Health Insurance Claim Reviewer

Job Description Job Description: We are seeking a detail- oriented and experienced Health Claims Specialist to join our team. The ideal candidate will be responsible for accurately processing and adjudicating medical claims in accordance with company policies, industry regulation, and contractual agreements. The Health Claims Specialist will play a crucial...

Job Description - High Value Claims Management - Cashless claims - Setting up guidelines for processing health cashless claims - Seek expert opinion on rejection/repudiation of HV claims. - Active coordination with ILM for closure of investigations within TAT - Medical Guidelines Cashless Claims Management - Set up medical claim processing criteria. - Set...

We are seeking a Claims Analyst to support our operations in Hyderabad. The successful candidate will provide technical assistance for commercial and personal insurance coverage, including liaison work with clients and carriers, disseminating needs, and facilitating requests.The key responsibilities of this role include obtaining claims data, evaluating...

Job 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...

Function PurposeThe Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, maintain client satisfaction, and uphold the credibility of the organization by adhering to ethical and legal standards.Role PurposeThe purpose of...

Job Description Company Description Liberty General Insurance Limited, established in 2013, is a prominent provider of retail, commercial, and industrial insurance solutions in India. A joint venture with Liberty Mutual Insurance Group, Enam Securities, and DP Jindal Group, the company operates across 60 offices in 58 cities and partners with a robust...

Job Description Location: Hyderabad (Hybrid) Work Hours 9:00 AM 06:00 PM Experience Required 02 years in veterinary/medical insurance claims processing or related domain Who We Are Quadrantech Pvt. Ltd. is a trusted partner offering comprehensive IT, BPO, and cybersecurity services, with strong expertise in healthcare and insurance administration. Guided by...

Job Description - Claims operations On monthly basis, monitor key performance parameters such as - Claims settlement TAT - Claim Settlement Ratio - Efficiency ratio, etc.; - Track deviations against set targets and identify reasons for deviations - Closely monitor and control the high ageing open claims, including co-insurance claims - Review the reserve...

Job Description Primary Job Responsibilities: 1. Scrutinization & Claim Status Updation: - Review claim documents for completeness and accuracy. - Update claim status on the ARIBL Claim Portal based on received documents. - Flag discrepancies or missing information for timely resolution. MIS Maintenance & Analytics: - Maintain a comprehensive MIS for all...

Job Description Job Purpose: The primary responsibility of this role is to manage and service Group Personal Accident (GPA) claims, ensuring efficient processing, proper documentation, and timely resolution. The role requires maintaining an updated claims database, coordinating with claimants, handling queries, and ensuring adherence to claim settlement...