Claim Processor

1 week ago


Gurugram Hyderabad Mumbai, India Career Shaper Full time ₹ 8,00,000 - ₹ 12,00,000 per year

OPEN FOR FRESHERS BHMS AND BMS DOCTORS

Knowledge of Claims processes: Indemnity (Cashless, Reimbursement), Fixed Benefit Products

  • Understanding of Claims systems (process flow & System fields) Health, PA & Travel
  • Experience in measurement of performance (TAT, accuracy in claims adjudication)
  • Expectations management of the Claims team
  • TAT & expectations management for specialized business handling.
  • Ensure uniformity in quality & maintain TATs of Claims decisions
  • Create & maintain standards/protocols for Claims team
  • Audit claims decisions in adherence & compliance with the Claims guidelines, uniformity in decisions, and approval authority limits (In house and TPA claims)
  • Periodic portfolio analysis: profitability (loss ratio / combined ratio), analyze frequency and severity, medical inflation
  • Maintain a consistent service delivery to ensure client retention and satisfaction
  • Identify risks to the company and escalate accordingly
  • Execution of processes and projects operations, to be in line with defined standards
  • Inputs for refinement and development of claims guidelines, policies, and procedures.


  • Hyderabad, Telangana, India beBeeClaimProcessor Full time ₹ 9,00,000 - ₹ 12,45,000

    Job DescriptionThe role of an Insurance Claim Processor involves handling cashless insurance claims efficiently and accurately.This position requires verifying policy coverage, reviewing medical records, and coordinating with Insurers to ensure timely closure to policyholders.The processor may also be responsible for communicating with employees or...

  • Claims Processor

    1 week ago


    Hyderabad, India Tecra Systems Pvt Ltd Full time

    We are looking for a "claims processor" for medical/health insurance related to our IT-enabled services division. **Roles and Responsibilities** To be able to learn and work on new categories / customers that comes up regularly. To be able to process 700 Claims per day with 99% accuracy. **Requirements**: Any graduate/diploma holder. Knowledge in...


  • Navi Mumbai, Maharashtra, India beBeeClaims Full time

    **Job Description:**As a claims processor, you will be responsible for delivering business solutions that support the healthcare claim function, leveraging knowledge of processes and systems to receive, edit, price, adjudicate, and process payments for claims.**Key Responsibilities Include:Processing and editing claims dataPrice and adjudication of...


  • Mumbai, Maharashtra, India Joulestowatts Full time

    Are you a fresh graduate looking to kickstart your career in the healthcare industry? Accenture Client Payroll - J2W is hiring for the role of Claims Processor (Non-Voice Process) in Airoli, Mumbai. As a Claims Processor, you will be a key player in providing business solutions for the healthcare claims function. This is a non-voice backend process that...

  • Claim Processor

    2 weeks ago


    Navi Mumbai, India HIRD SERVICES PVT. LTD. Full time

    Required Experience: - Experience 1- 3 years - Excellent communication skills - Should be flexible to work in rotational shifts - Proficient in computer usage and Basic knowledge on MS Office Job Role: - Execute claims processing for U.S Healthcare - Investigated high volume of insurance claims to determine validity, coverage eligibility and accurate...

  • Claims Processor

    7 days ago


    Prabhadevi, Mumbai, Maharashtra, India Watchyourhealth.com Full time

    Job profile: CRM helpdesk. CRM implants for claim support at client location Resolve customer queries on policy coverage and health claim processes Facilitate to drive claims app for submission and tracking of claims by employees Collect and dispatch claim documents as per corporate requirement Coordinate with internal claims units at IL to ensure...


  • Hyderabad, Telangana, India beBeeClaims Full time ₹ 10,00,000 - ₹ 15,00,000

    Claims Specialist Role OverviewOur organization is seeking an experienced claims specialist to support the evaluation and processing of insurance claims in the US insurance market. The ideal candidate will have a strong background in claims management, with excellent analytical, organizational, and problem-solving skills.Review and process insurance claims...


  • Gurugram, Haryana, India INK IT SOLUTIONS Full time

    We're looking for Claim Processing Associate (US Process) for Gurgaon location. Exp level: - 06 Months to 2 yrs POSITION OVERVIEW : Disability Management Claim Processor POSITION GENERAL DUTIES AND TASKS : *Handle claims related to disability management. *Determining customer - s disability coverage and verifying the information available in the system....


  • Gurugram, Haryana, India Vidal Health Insurance TPA Private Limited Full time

    Vidal is hiring for Claims-Executive Work Location: Gurgaon **Work from Office only** **Key Responsibilities** Claim processing which includes NME evaluation Tariff applicability Policy T & c Co-pay Discount deduction Investigation criteria knowledge Insurer wise policy T&C knowledge Basic Documentation required for claim processing Experience...


  • Mumbai, Maharashtra, India Robust Healthcare Solutions Full time

    **Role Description**: - Seeking a dynamic and experienced individual to lead our Claims and Insurance Process team. - Calling patient & hospital for verification **Core Role Responsibilities**: - Ensure timely and accurate processing of claims in compliance with industry standards and company policies - Maintaining high levels of confidentiality while...