OPD claim processor

About JobThe Medical Claim Processor is responsible for end-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT). This role requires close coordination with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient...

Job Description – OPD Health Claims Processing(MR)Key Skills & CompetenciesKnowledge of health insurance policy coverage, exclusions, and claim processing.Familiarity with claim categories (IPD/OPD/Pre-post health claims processing).Basic understanding of medical terminology and treatment protocols.Strong attention to detail and analytical skills.Good...

Greetings from Star Secutech Pvt LtdJob Role: CPE/SPE Dental ClaimsExperience: Minimum 1yr into Indian/International HealthcareJob Description:All the rest of countries except US claims are getting loaded in the portal (Octopus) in paper /electronic format.We have 2 baskets where the claims are pended.The coding basket has claims which are mainly for coding...

About JobMedical claim processSkills & QualificationProcess health claim & Insurance KnowledgeAnalytical & Decision-making SkillsCustomer Handling & CommunicationResponsibilitiesDocument ScrutinyAdmissibility AssessmentCoordination & CommunicationAnalysis & Reporting

About PlumPlum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as...

Job Title: Quality and Process Manager Health Claims OperationsLocation: BangaloreDepartment: Health Claims OperationsReports To: Head of Health ClaimsEmployment Type:Full-TimeJob SummaryWe are seeking a highly analytical and process-driven Quality and Process Manager to lead quality assurance and process improvement initiatives within our Health Claims...

Job Description:Check the medical admissibility of a High Value claim, scrutinize and process it as per terms & conditions of insurance policy.Handle escalations, customer queries and responding to mails accordinglyEffectively manage the team so that the targets are met while reducing the no. of IRs raised.Ensure that the claims are approved or denied as per...

Role & responsibilitiesPerform audit reviews of adjudicated health / hospital / medical claims to verify correctness, completeness, and adherence to policy guidelines, contractual terms, and regulatory norms.Use sampling and systematic review techniques (random audits, targeted audits, high-value claims audits) to ensure quality coverage across volumes.Check...

Job Description:Endevor Admin ( SCM Tool)Strong experience on CA Endevor SCM tool upgrade project.Experience on Endevor C1DEFLTS & ESI table and complete Inventory analysis.Experience on creating Endevor System/Subsystem/Type/Stage/Processor Group/Approval Group/Site Symbolic Etc..Strong Experience on Endevor processor coding and managing the processor...

Tomorrow is our home.Find out how you can enjoy, grow and perform at BSH Home Appliances Group: As a leading manufacturer of home appliances and solutions, we encourage commitment and open-mindedness among our employees. With our global brands Bosch, Siemens, Gaggenau and Neff as well as our local brands, our focus truly is on innovation. And that doesn't...