Claims Processing Doctor

Roles and ResponsibilitiesConduct thorough investigations into health insurance claims, including medical records review and witness statements gathering.Determine claim validity by analyzing policy terms, coverage conditions, and documentation.Coordinate with hospitals, doctors, and other stakeholders for smooth claim handling.Ensure compliance with...

Job Summary:We are seeking a qualified and experienced medical professional with a strong background in health insurance claim settlement and customer service. The ideal candidate will leverage their clinical knowledge to evaluate and process health insurance claims efficiently while ensuring a high level of customer satisfaction. This hybrid role bridges...

Should possess U.S Health insurance claim processing experienceKnowledge of medical billing and coding terminologiesReady to work in Night Shift as well as Day shiftUnderstanding of plan documents and general benefitsFamiliarity with terms such as deductible, out of pocket, coinsurance, and copayStrong attention to detail and accuracyAbility to work in...

Role & responsibilitiesProcessing of pre-authorization/cashless claim.Maintain processing TAT for pre-auth/cashless claimMust be able to analyze large amount of data, Identify patterns and draw conclusions from that dataMust have previous experience of conducting audit, sampling and preparing reportsReviewing insurance policy documents to determine coverage...

Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our...

Role & responsibilitiesTeam Management: Lead and mentor a team of claim processors, surveyors, and support staff to ensure seamless claims settlement.Claims Processing: Oversee the end-to-end claim life cycle from registration, assessment, and documentation to final settlement.Vendor Coordination: Manage relationships with surveyors, garages, and loss...

Role & responsibilitiesManaging Billing team to meet the SLAs as per Insurers.Monitoring the quality in all the processes of billing.Monitoring claims allocation for billing.Tracking of outstanding claims under billing.Handling escalations from all stakeholders for Billing and resolving them.Interested candidates can call or refer to Moulika @ ,

Roles and ResponsibilitiesManage insurance claims from receipt to settlement, ensuring timely and accurate processing.Conduct thorough analysis of claim documents, including medical records, police reports, and other relevant documentation.Identify potential fraud risks and take necessary actions to mitigate them.Collaborate with internal stakeholders, such...

DescriptionClaims Reporting & Evidencing:Loss notification to the underwriter within 24 hours of Mumbai receiptProcuring Claim related information (claim number and adjustor information ) from the underwriters and relaying it to the clientEvidencing of claim related information and addressing the received queries in liaison with the Claims Advocate Group...

Job Description Industry: General Insurance / Insurance Broking / Insurance SurveyorLocation: MumbaiExperience: 12+ yearsReporting To: Business Head/Vertical HeadRole SummaryThe role holder will lead the claims function across all Specialty lines of business, ensuring efficient, compliant, and client-centric claims handling. The role involves strategic...