Quality - Sme

6 days ago

Bengaluru Karnataka, India Star Secutech pvt ltd Full time

**Job Role**:QA -Claim Adjudication

**Location**: Bangalore

**Shifts**: US Shift

Both the way cab available

5 Days working (Saturday & Sunday fixed off)

**Salary**:5.5-6 LPA + incentives + allowance

**Experience**:Minimum 3+ years of experience in claims adjudication, with at least 1 year in a SME on papers.

**Key Responsibilities**
- Auditing Claims: Reviewing adjudicated claims to verify the accuracy of decisions, compliance with client guidelines, and adherence to healthcare/insurance standards.
- Quality Monitoring: Tracking and analysing performance metrics, preparing reports, and sharing insights to improve the claims processing function.
- Compliance: Ensuring all processes and handling of member/provider data comply with regulations such as HIPAA.
- Collaboration: Working with operational teams to implement corrective measures and improve training programs.
- Knowledge Management: Developing and maintaining a thorough understanding of insurance policies, products, and the broader healthcare insurance industry.

**Key Skills & Qualifications**
- Technical Skills: Proficiency in claims adjudication systems, quality management tools (like the 7 QC tools), and methodologies like Six Sigma.
- Analytical & Problem-Solving Skills: Ability to analyze complex data, identify discrepancies, and develop effective solutions.
- Knowledge of Regulations: Strong understanding of industry regulations, insurance policies, and legal standards.
- Communication Skills: Effective communication to share insights and collaborate with different teams and stakeholders.
- Attention to Detail: Crucial for accurately verifying documentation and ensuring the completeness of claim information.

**Job Types**: Full-time, Permanent

Pay: ₹450,000.00 - ₹600,000.00 per year

**Benefits**:

- Health insurance
- Leave encashment
- Paid sick time
- Paid time off
- Provident Fund

**Education**:

- Bachelor's (required)

**Experience**:

- claims adjudication: 1 year (required)

**Location**:

- Bangalore, Karnataka (required)

Shift availability:

- Night Shift (required)

Application Deadline: 15/10/2025
Expected Start Date: 13/10/2025

  • Sme

    8 hours ago

    Bengaluru, Karnataka, India PhonePe Full time

    **About PhonePe Group**: PhonePe is India’s leading digital payments company with 50 crore (500 Million) registered users and 3.7 crore (37 Million) merchants covering over 99% of the postal codes across India. On the back of its leadership in digital payments, PhonePe has expanded into financial services (Insurance, Mutual Funds, Stock Broking, and...

  • IT Warehouse

    4 weeks ago

    Bengaluru, Karnataka, India, Karnataka AVASO Technology Solutions Full time

    Position : SME - IT Warehouse Location: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • Sme

    1 week ago

    Bengaluru, Karnataka, India Gameskraft Full time

    ID: 1058 | 3-5 yrs | Bengaluru | careers About Gameskraft Established in 2017, Gameskraft has become one of India’s fastest-growing companies. We are building the world's most-loved online gaming ecosystem, one game at a time. Started by a group of passionate gamers, we have grown from a small team of 5-6 members to a large family of 600+ Krafters,...

  • Functional Sme(Qtc)

    1 week ago

    Bengaluru, Karnataka, India Qualitest Full time

    **Date**:11 Jul 2025 **Company**:Qualitest Group **Country/Region**:IN Functional SME Must Skills - Expertise in SAP MM/SD/WM Testing - 5/5 Expertise in Integration Testing - 5/5 Test lead experience - 4/5 Roles & Responsibilities: - Expertise on SAP SD/MM/WM processes - Good experience in testing large and complex SAP projects - Participation in...

  • IT Warehouse

    4 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT Warehouse Location: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • It Warehouse

    4 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT Warehouse Location: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • IT Warehouse

    4 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT Warehouse Location: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • IT Warehouse

    4 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT WarehouseLocation: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • IT Warehouse

    4 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT Warehouse Location: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...

  • It warehouse

    2 weeks ago

    Bengaluru, India AVASO Technology Solutions Full time

    Position : SME - IT WarehouseLocation: BangaloreAbout the Role We are seeking a highly professional and polished IT Warehouse Subject Matter Expert (SME) to oversee depot operations at our India Depot. The ideal candidate will bring strong experience in IT asset management combined with warehouse and depot management expertise. This role requires a...