671 Claims Processing Jobs - Page 7

Hiring For Motor Claims Motor Claims Insurance OR Any General Insurance Claims exp + International Voice. Should have excellent communication skills; Effective communication/ articulation with clients. Candidate should be able to explain on the current roles and responsibility in detail. Exp in Motor Claims Insurance OR Any General Insurance Claims 3 to 6 years is mandatory. 2+ years of international voice is mandatory. Candidate should be based in Bangalore itself. NP - Immediate to 60days 70% will be voice & 30% will be email communication Package upto 5.5LPA For More Information Contact Nikita-7983523840

Role & responsibilities: Data Entry/Onboarding of claimants in Salesforce. Reviewing claimants bankruptcy (legal) documents, maintaining account documents/files, sending LOI, sending and responding to emails, etc. Coordinating with members of onshore team and departments entwined with service line. Additionally, handling communication with Trustee, Assistant US Trustee, and Bankruptcy Attorney, and firm representatives via emails/callsto resolve the lien in timely manner without any escalation. Responding to all emails received personally or in mailbox within given TAT as per the SOP or 24 hours Maintaining service line tracker, account documents and files with precision. Keen eye forlittle details and ability flag potential problems and resolving them before they become major escalation. Will be responsible for overlooking junior team members work, addressing there queries, mentoring and shadowing them. Assisting team leader in maintaining as well as creation of SOP/Checklist and training material. Assist with other administrative special adhoc projects as needed. Coordinating with in-house teams like quality, training etc. for learning and development. Adhering to company policies/ARCHER principles and hence taking good care of Archer culture. Preferred candidate profile: Bachelor's Degree (Preferably Commerce Background) 3+ Yrs. with international KPO predominantly working with US clients. Specifically, domains which include email communication and auditing. Intermediate/Advance Excel, Proficiency with Outlook, Time Management Data entry skills: A typing speed of at least 40 WPM to keep up a standard level of efficiency at work. Additionally, it requires accuracy, attention to detail, and analyze/manage large amounts of data. Intermediate Excel (Pivot Tables, VLOOKUP, Functions, Tables, Formatting etc.) Proficient Outlook (Create Rules, Manage Folder, Manager Calendar, etc.) " Communication Skills - Written & Verbal - the ability to critically assess a given body of information and draw conclusions independently.

Role & responsibilities Timely process business enquiries Pre-underwiring, Data analysis, develop quotation sheet Perform web search and review info through various sources Perform risk assessment based on financial and non-financial information Timely and accurate prepare underwriting referral for senior underwriters Proactive engagement with underwriting to ensure for new and renewed accounts an efficient and smooth account hand over, to ensure information received is understood and complete in order to process / instruct policies on system(s). Ensures timely and complete documentation of files handled by role holder in UW file (on document management system). Keeps track of implementation progress and liaises with local staff to resolve queries etc. of an account globally (per defined KPI) and proactively take appropriate action. At request of Underwriting, ensure timely and high-quality implementation of mid-term endorsements, issuance of certificates of insurance. Ensure appropriate communication flow between Underwriting and EO and network for mid-term endorsements. Foster positive relationship with internal/external counterparts to get a mutual understanding of their needs. Preferred candidate profile Educated to at least Graduation or similar like BCom, BBA, CA Intermediary etc. Any insurance related qualification is a plus Experience: Minimum 3 years of experience post-graduation in any type of business/financial analysis Strong communication: Excellent verbal and written communication, collaboration, presentation and influencing skills. Able to communicate effectively with internal and external stakeholders at all levels of sophistication. Ability to work in a fast-paced environment and efficiently juggle numerous concurrent responsibilities. Attention to detail Time Management Continuous Improvement Focused Results Oriented

Responsible to review and delivery of complete claim life cycle with indepth analysis. Categories the claim criticality as high, moderate and low. Refer/review the contract agreements thoroughly to identify the shortfalls in claim process. Ensure maximizing the collections from claim. Accurate in ensuring exact & prompt documentation of information. Ensure to deliver the tasks within set timelines. Categories the claim criticality as high, moderate and low." style="white-space: normal;">Responsible to review and delivery of complete claim life cycle with indepth analysis. Categories the claim criticality as high, moderate and low. Refer/review the contract agreements thoroughly to identify the shortfalls in claim process. Ensure maximizing the collections from claim. Accurate in ensuring exact & prompt documentation of information. Ensure to deliver the tasks within set timelines. Categories the claim criticality as high, moderate and low.

Tele Callers – 05 Team Leader – 01 Compliance Officer – 01 knowledge of IRDA regulations insurance broking compliance Underwriter – 01 from the insurance industry Claims Executive – 01 Position relevant experience in insurance claims. Required Candidate profile JOB LOCATION WAGHOLI ,PUNE . TELECALLERS ,TEAM LEADER ,COMPLIANCE OFFICER ,UNDERWRITER ,CLAIMS EXECUTIVE ALL HAVING EXPERIENCE IN LIFE & HEALTH INSURANCE SECTOR EARLY JOINING NEEDED Perks and benefits PERKS & BENEFITS AS PER INDUSTRY STANDARDS

Summary of the role: 100% adherence to Insite and Prato Insta process Update all the treatments in INSTA daily with 100% accuracy. Book GRN the very same day whenever material received with 100% accuracy. Book consumption in EuCliD daily with 100% accuracy. Cost optimization: Proper utilization of Consumable per treatment, Electricity, water, proper Management of patient and staff roster, repair and maintenance cost, local purchase, petty cash and etc. Generation of Management Information reports viz. (Consumable reports, Daily revenue reports, patient data Etc...). Responsible for updating of allied government schemes and claim process. Follow up patients scheduling and maintains report with patients, managers, and employees by arranging continuing contacts. Should maintain Patient details along with addresses and contact numbers. Responsible for rising indents in consultation with Sr. Technician. Responsible for sending his & the technician s attendance on daily basis. In coordination with operation timely submit invoices and follow-up for the payment. In coordination with clinical staff s ensure proper up time of network and complete admin related EuCliD activities. Adherence - Company Policies Ensure adherence to company s time & attendance policy Ensure adherence to company s code of conduct & Compliance Maintain the team camaraderie/harmony Drive effectively the positive environment for Unit 100% accuracy in reporting Material receivable and properly organizing materials in storeroom Dispensing daily consumable to clinical staff. Close monitoring on patient wise consumption

Good knowledge in Denials, appeals, rejection/claims, correspondence Knowledge in RCM & AR fundamentals Good Communication is Mandatory No Cab Facility Sat & Sun fixed week off Direct Walk in Only Priyadarshini HR Recruiter :9363752251

Please take some time to review the JD and the project information, as they will give you a deeper understanding of the role and responsibilities. If you have any questions or need further clarification, do not hesitate to reach out to us. We are here to provide you with all the support and information you need during this process. Client- Optum Position: Quality Analyst Location: Hyderabad Location: Optum Global Solutions, (Avans)Phoenix Info city Private Ltd, Site 4, 1st floor, SEZ, Hitec City, Hyderabad, 500081. Interview Process: Face to Face Contract base Job Payroll will be Joulestowatts Business Solutions experience: 6months to 3Year Location Hyderabad Work module Work from office Cab facility - Both way cab provided Notice period Immediate Nature of work: Non-Voice Amenities: Deployment at Client location Transportation – Home Pickup and Home Drop facility within transport radius. Pantry Services – Regular Tea, Green Tea, Coffee, Milk with Sugar/Jaggery available round the clock. Selection process: Candidates need to be available in Optum premises during the Interview process, no scope of virtual interview. 1st round – Typing Assessment (30 WPM, 95% accuracy) 2nd round – Written assessment (Analytical, Reasoning, US Healthcare) 3rd round – Line Manager Round 4th round – Final Round Need to carry pens along Need to be in formal attire Shift timings: 5:45 PM to 3:15 AM (Night shift) primarily, however they may be asked to work in morning shift as well on need basis. Hence candidates must be flexible to work in both the shifts. It’s the peak season. Hence candidates must be ready to work overtime on weekdays/weekends when required as CLRA guidelines. OTs are payable additionally. Role: Quality Analyst (Contractual/Temp – Would be converted purely based on performance) Salaries + Incentives: Package 2.4 LPA + Additional Incentives Incentives Rs.400 for 100% attendance (monthly) Rs.200 is allocated towards team outings and team refreshment activities (monthly) Top 10% of the performers would receive a GV worth Rs.1000 (monthly) Rs.400 per month towards Project retention bonus which would be accumulated and released along with FnF. Candidates serving the entire tenure of the program are eligible for it. If interested kindly share cv

Cognizant is hiring Senior Process Executive with Claims Facets experience. Skill: Claims Facets Experience : 1 Year to 4 Years Notice: Immediate to 15 days preferred Shift - Night Shifts (US Shift) Preferred Locations: Hyderabad, Chennai, Bangalore, Coimbatore, Pune, Noida Desired Profile: Minimum 12+ months of experience in Claims-Facets (Mandatory) Graduation is a must Should be willing to work in Night shift - US Shifts It is a WFH opportunity (temporary) but should be flexible to work from office if required Note: Candidates with Claims Facets experience from RCM-US Healthcare’ are only eligible for the position. Applicants with relevant experience can forward the cv to: Naga.SatyaTanujaSri@cognizant.com

Basic Purpose:Provide timely and accurate response to assigned internal and external customers Collaborate with underwriters to establish target dates and communicate coverage recommendations.Responsibilities to include account set-up, quoting, proposals, policy issuance, policy administration requests, and account service.Assist in reviewing documentation received for completeness and request missing informationDocument and maintain unit processes and procedures and disseminate information to the applicable team.Other responsibilities as needed.Primary Job Responsibilities:Screen transactions to determine authority and process and/or refer to underwriter per established guidelines.Gather a wide variety of rating elements from applications/UW instructions/WC rating bureaus/NCCI/ /Reference Connect and company guidance to rate new or renewal business.Input information and rating elements into the policy rating system with a high degree of accuracy. Review output to ensure proper rating elements were applied.Maintain rating documentation using paperless policy environment per established guidelines.Provide endorsement quotes on demandDevelop relationships and work within team and across departments to ensure customer tasks are completed and customer response expectations are achieved.Initiate and facilitate renewal process in collaboration with underwriter and timely, professional communication with producer.Resolve customer service issues.Ensure proper initiation and completion of incoming requests for policy issuance, quote requests, Endorsement and policy administration.Identify areas for improvement, with recommendations for process, procedure, or system changes. Qualifications Qualifications, Skillset and Experience:Minimum 6+ months experience in P&C Insurance background within Underwriting Support experience (Issuance, Endorsements) required for AssociateMinimum 12+ months experience in P&C Insurance background within Underwriting Support experience (Issuance, Endorsements) required for Sr. AssociateOrganizational and interpersonal skills to set priorities, manage time, and be responsive to assigned customers.Demonstrated ability to professionally communicate and collaborate with internal staff and external customers.Solutions mind-set, passion for the customer serviceExcellent Communication skills verbal and written. Fluent proficiency & comprehension in English is required.Strong ability to multi-task while effectively communicating with the customersEfficient in internet, computer usage and web-based application skills. Typing speed of 30+Eye for DetailEducational Qualification :Attended at least 2 years in CollegeGraduate / Under GraduateOthers :Ability to perform work from Office Willingness to work in shifts. Work may extend beyond normal business hours as per business requirements NoteThis job description in no way states or implies that these are the only duties performed by this employee. Employees may be requested to perform job-related tasks other than those specifically presented in this job description. The employer reserves the right to change or assign other duties to this position. Job Location

Minimum of 8 years of experience in a management roleProven track record of successful leadership and team managementAbility to develop and implement strategic plansExcellent communication and interpersonal skillsStrong problem-solving and decision-making abilitiesExperience in budget management and financial analysisKnowledge of Motor Claims industry trends and best practicesBachelors degree in business administration or a related fieldMasters degree in business administration or a related field preferredProfessional certifications such as CII, PMP, Six Sigma, or CFA are a plusStrong leadership and management skillsExcellent analytical and critical thinking abilitiesAbility to work well under pressure and meet deadlines Qualifications Graduate with Motor Claims certification preferable Job Location

We are looking for a motivated and enthusiastic analyst with an unwavering 'can-do' attitude to join the Commercial Engineering team. As a part of the Commercial Engineering team you will contribute to the design, prototyping, testing, deployment, performance, security, and enhancement of Thomson Reuters' Commercial Engineering systems/applications. You will also participate in a wide range of business analysis, project management, strategic planning, product management, and escalated support activities. About The Role: Bachelor's degree in accounting, business, or computer science Unyielding attention to detail Highly organized with strong analytical andproblem-solvingskills Ability to collaborate and brainstorm with developers, other departments, and product users in a highly dynamic environment Strong planning and time management skills, with a proven track record of managing multiple concurrent projects with time-sensitive milestones Must be able to work independently with minimal direction and guidance to achieve established goals and objectives Excellent verbal and written communication skills Ability to deliver high quality work on time in a high-energy, rapidly changing environment About You: Formulate and define complex information systems scope and objectives through research, analysis, and testing combined with a basic understanding of business needs, industry requirements, and best practices. Translate internal and external feedback to design solutions that satisfy user and business needs while managing expectations and relationship risks. Resolve problems of complex and diverse scope where the effective analysis of data often requires an accurate evaluation of identifiable and/or contributing factors Analyze and communicate extensive research findings into relevant and applicable insights Exercise independent judgment and resourcefulness within the scope of generally defined practices and policies in selecting the most appropriate methods and techniques for obtaining optimal solutions. #LI-KP2 Whats in it For You Hybrid Work Model Weve adopted a flexible hybrid working environment (2-3 days a week in the office depending on the role) for our office-based roles while delivering a seamless experience that is digitally and physically connected. 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Job Title : Medical officer Open Positions: 2 Vacancies Location: Konankunte cross Job Summary: We are seeking candidates with a minimum of 1 year of experience in Indian health Insurance/TPA (Added Advantage) who have strong communication and along with good medical knowledge in Claims Adjudication. Qualifications : Degree in BAMS, BHMS, BSMS, or MBBS (strictly required). Candidates who can join immediately or within 15 days are preferred. Roles & Responsibilities: Ensuring accuracy and compliance in medical claims adjudication. Knowledge & Skill Requirements: Technical Competencies: Claims processing Preauthorization, Cashless, Reimbursement, Medical Adjudication, and Billing experience. Understanding of GIPSA/MA packages, SOC, and Tariff deviations. Identifying bill inflations in insurance billing. Knowledge of surgeries, advanced treatments, and procedure costs. Behavioral Competencies: Strong communication skills (verbal & written). Teamwork and collaboration. Time management and multitasking.

Role Purpose: The Contracts Lead will oversee all aspects of contract administration, risk management, and project closure claims for the assigned projects. The role will involve advising the project execution teams (of the applicable projects allocated) on interpretation of contractual terms, evaluating contractual risks, and ensuring proper claims management. This position plays a key role in aligning the contractual obligations with project execution to mitigate risks and resolve disputes in a proactive manner Key Accountabilities : Contractual Advisory & Guidance • Act as the key advisor for the project execution teams on interpreting contract terms, conditions, and obligations • Ensure that project teams understand the implications of contract clauses and recommend necessary actions to mitigate risk • Support the informal dispute resolution process by providing strategic advice related to contract terms Management of Project Level Documentations • Train and support Project Team Members of the BUs projects to ensure consistency and adherence to document control protocols • Oversee and improve project level documentation practices, for maximum adherence to central documentation SOPs/policies Contractual Risk Evaluation & Assessment • Evaluate and assess contractual risks at the project level, identifying potential liabilities or deviations from the SoW • Proactively assess contractual risks associated with key project deliverables, payment delays, CoS, EoT, and more Vetting of Contractual Correspondences • Review and vet contractual correspondences to ensure alignment with contractual provisions • Ensure that such communications are compliant with contract stipulations and are handled professionally and with full documentation Claims Management during project cycle • Identify pending claims and unresolved issues related to the projects closure, by categorizing claims as per applicable reason of delays • Collate all relevant records supporting project closure claims, including notices, logs, approvals, and communications; to finalize Statement of Claims (SoC) for unresolved issues SOPs and Guidelines • Contribute to the development and maintenance of SOPs and guidelines for contract and claims management within the applicable projects • Ensure the consistent application of SOPs across all assigned projects and compliance with legal and regulatory requirement Collaboration with other teams • Assist Project Execution Teams in informal settlement discussions and ensure they are aligned with contractual obligations and future risks • Liaise with the legal team as required, particularly in relation to ADR processes and formal dispute proceedings

We are hiring freshers or experienced medical officer to process the health insurance claims in TPA or Insurance companies. Educational Qualification: MBBS / BAMS / BHMS / BPT / MPT / BDS / Pharm D.

About the company Hiring for one of the Top Multinational corporation !!! Job Title : Marine | End-to-end Claims Insurance Qualification : Any Graduate and Above Relevant Experience : 3 to 7 years Must Have Skills : 1.Insurance regulations and laws 2.Claims handling procedures 3.Risk management principles 4.Industry standards 5.Maritime law and regulations 6.Investigate and analyze claims documentation 7.Determine coverage and liability 8.Negotiate settlements and resolve disputes 9.Communicate effectively with insureds, claimants, suppliers and brokers 10.Apply industry-standard claims handling procedures. 11.Collaboration and teamwork Good Have Skills : Experience in Marine claim Adjuster Roles and Responsibilities : 1.Investigate the circumstances surrounding marine incidents, such as collisions, groundings, or cargo damage. 2.Assess the extent of damage to vessels, cargo, or freight, and estimate the cost of repairs or replacement. 3.Appropriately document information on claim file Maintain effective and ongoing communication with various internal and external contact. 4.Learn and follow best practices of clients as well as claims requirements, standards and practices as required by applicable state statutes. 5.Ensure compliance with relevant maritime law and regulations Ensure adherence to regulatory requirements, industry standards, and company policies. 6.Mitigate organizational risk, maintaining compliance and reputation Location : Kochi, Pune, Mumbai and Bangalore CTC Range : 4.5 7.5 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Hybrid -- Thanks & Regards, Darini HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432492 | WhatsApp 9591269435 darini@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Role and Candidate Expectations: Candidate 4-8 years of experience in global benefits Language Proficiency: Native-level fluency in English (both verbal and written). Experience in payroll processing claims & vendor file SFTP Experience in Pension enrollments and updates Experience in wellness benefits and group health insurance and medical benefits Experience in pre and post pension payroll and active payroll checks Experience in supplier invoicing collaboration with finance teams Proficient in Darwin Workday and Service Now tools. SLA & KPI Adherence Must be flexible to work in shifts Contact Person: shalini Contact Number: 9840116523 Email ID: shalini@gojobs.biz

Guidewire Claim Center Developer

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on varsha.kumari@mediassist.in Thanks & Regards Varsjha Kumari Email - varsha.kumari@mediassist.in

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Roles and Responsibilities: For Payment Posting: Posting insurance and patient payments into the billing software accurately. For AR Calling: Calling insurance companies in the US to follow up on unpaid or underpaid claims. Over time allowance Gratuity

Urgent requirement for BHMS/BAMS/BDS doctors-Pune (Vadgaonsheri) Candidate with clinical or TPA experience Interested candidates can call on 7391042258 (Sneha- HR department) or share their updated resumes to recruitment@mdindia.com Roles and responsibilities: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BAMS / BHMS / BDS graduate. Good Medical & basic computer knowledge. Should have completed internship (Permanent Registration number is mandatory) Preferred -TPA or insurance sector Experience. Work from office . Interview Timings-11am To 5pm(Monday To Saturday) Venue Details: MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 4th floor, Pune Nagar Road, Vadgaonsheri, Pune 411014

Skills Skill Medical Coding Healthcare CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 HIPAA Education Qualification No data available CERTIFICATION No data available Role Description Overview: Coder is accountable to manage day to day activities of coding the Patients chart & Diagnosis report. Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Skills Skill Medical Coding Healthcare HIPAA CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 Education Qualification No data available CERTIFICATION No data available Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Skills Skill Medical Coding Healthcare HIPAA CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 Education Qualification No data available CERTIFICATION No data available Role Description Overview: Coder is accountable to manage day to day activities of coding the Patients chart & Diagnosis report. Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports