Medical Claims Review Senior Analyst
7 days ago
Medical Advisor The Medical Advisor is a member of the medical team which develops and manages health and wellness programs for Cigna customers Together with a team of nurses and physicians she he will ensure attainment of quality production timeliness cost containment goals and excellent customer satisfaction for both internal and external customers Ability to review investigate and respond to external and internal inquires complaints Provides guidance and acts as a mentor or coach for the nurses and other non-clinical staff He she works with a multicultural population and is constantly aware of the cultural differences among that population and the geographical regions Major responsibilities and desired results Part of a clinical team that provides evidence based medical management services to customers worldwide Give evidence-based advice on medical claims taking into account compliance internationally accepted protocols and local and or regional customs and regulations Support and monitor the case management disease management and other clinical services and assure quality of performance against QA standards to promote optimal service delivery and ensure accurate statistical data and reports Give advice on appropriate corrective action if necessary Assist in fraud detection Assist is the coordination of processes for improving quality of care and health outcomes for specifically delineated projects or populations Excellent communication and facilitation skills are keys to success Assist and support the team in cost containment assist in projects and service delivery to meet goals Work together with the team on quality improvement and clinical management projects within Clinical Operations Serves as a resource educator regarding specific areas of expertise Able to create and implement appropriate educational clinical programs content for internal and external audiences and link with Cigna University resources Other duties as assigned Location India Languages English fluent and any additional language will be considered Experience Medical Degree 3 years of experience in insurance sector would be an asset About The Cigna Group Cigna Healthcare a division of The Cigna Group is an advocate for better health through every stage of life We guide our customers through the health care system empowering them with the information and insight they need to make the best choices for improving their health and vitality Join us in driving growth and improving lives
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Claims Senior Supervisor
3 weeks ago
Bangalore, Karnataka, India Cigna Full timeThe Claims Senior Supervisor oversees the day-to-day operations of the claims team based in both KL India work in collaboration with peers and other supervisors ensuring timely and accurate processing of claims in accordance with company policies and regulatory requirements This role provides leadership guidance and support to claims staff monitors...
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Medical Officer – TPA Claim Process
3 days ago
bangalore, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: Vadodara Reporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Claim Executive
5 days ago
Whitefield, Bengaluru, Karnataka, India Vidal Health Tpa Private Limited Full timeJOB DESRCIPTION: The role involves auditing claims and preauthorization, to ensure clinical appropriateness, policy compliance, and correct system processing. It requires a strong blend of medical understanding and system knowledge to identify errors, investigate their root causes, and support in improvement of workflows. **Key Responsibilities** 1.Review...
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Claims Specialist
2 weeks ago
bangalore, India Plum Full timeAbout Job:-Claims Management Specialist is responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers.The job purpose of a Claims Management Specialist is to process and manage cashless claims for employees. This includes verifying...
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Claims specialist
4 weeks ago
Bangalore, India Plum Full timeAbout Job:- Claims Management Specialist is responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers. The job purpose of a Claims Management Specialist is to process and manage cashless claims for employees. This includes...
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Claims Representative
3 weeks ago
Bangalore, Karnataka, India The Cigna Group Full timeAbout UsAt CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection Responsible Growth is how we run our company and how we deliver for our clients teammates communities and shareholders every day One of the keys to driving Responsible Growth is being a great place to work for our...
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Medical Reviewer
3 days ago
Bengaluru, Karnataka, India Novo Nordisk Full timeMedical Reviewer **Category**:Clinical Development **Location**:Bangalore, Karnataka, IN **Novo Nordisk Global Business Solutions (GBS) India** **Department - Centralised Monitoring Unit (CMU)** **About the department** The Centralised Monitoring Unit (CMU) - Bangalore, is a department within the Clinical Drug Development area. It is a perfect blend of...
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Medical Reviewer
7 days ago
Bengaluru, Karnataka, India Natobotics Technologies Private Limited Full timeRole -Medical Reviewer Qualification: MBBS/MD only (MCI Certification is not mandate**) Experience Range: 1 to 7 Years Preferred Experience: Minimum of 1-5 years of experience in PV/ Clinical Research (drug safety) Location: Mumbai/ Pune/ Nagpur/ Gandhinagar/ Bangalore/ Chennai/ Indore. Roles & Responsibilities - Author a company clinical comment (CCC)...
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Bangalore, Karnataka, India Angel & Genie Full timeAnalyst - 3 yrs - 5-8L - 4 openings TL - 5 yrs - 8-11L - 3 openings Manager - 10 yrs - 11-17L - 2 openings Senior Manager - 13 yrs - 17-24L - 2 openings Position Overview To play a critical role within the Content team contributing to the development enhancement and maintenance of medical policy content This position is responsible for researching new...
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Medical Reviewer
2 weeks ago
Mysuru, Karnataka, India Sitero LLC Full timeESSENTIAL DUTIES AND RESPONSIBILITIES: - Analyzes, reviews, and interprets safety data, both non-clinical and clinical. - Performs medical review of ICSRs, and other drug safety information from multiple sources, including clinical trials, spontaneous and solicited reports, aggregate and literature reports. - Provides technical and medical expertise in...
