3,374 Claim Processor Jobs in Mahbubnagar

Key Responsibilities: Medical Review & Claims Adjudication: Assess and validate medical claims based on clinical documentation and policy coverage. Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility. Coordinate with internal medical teams to ensure accuracy in claims decision-making. Customer Interaction & Support: Communicate with policyholders, hospitals, and third-party administrators (TPAs) to explain claim decisions in a clear and professional manner. Handle escalated or complex customer service issues involving medical claims. Offer support and guidance on claim submission processes and documentation requirements. Compliance & Documentation: Ensure all claims are processed in compliance with IRDAI regulations and internal guidelines. Maintain accurate records of claim assessments, approvals, denials, and communications.

Insurer & Internal Query Management. Claims Processing Reimbursement & Cashless Insurer Relationship Management. TAT Monitoring & SLA Compliance Reporting & Process Improvement. TAT and SLA monitoring MS Office

TOP MNC HIRING: AR CALLERS US HEALTHCARE PROCESS Location:  BangaloreShift: Night Shift (US Time Zone)Position: AR Caller US Medical Billing (Revenue Cycle Management)   Kickstart or Accelerate Your Career in the Growing US Healthcare Industry! A leading multinational company is seeking energetic, goal-oriented individuals to join its dynamic Accounts Receivable (AR) Calling team. Whether you're a fresher eager to start your career or an experienced professional in US Medical Billing, this is your opportunity to grow in the global healthcare space.    Key Responsibilities: Make outbound calls to US insurance companies to follow up on outstanding medical claims. Analyze and resolve claim denials and underpayments. Review and interpret Explanation of Benefits (EOBs) and take necessary action. Maintain accurate records of all communications and claim statuses. Collaborate with internal teams to meet service level agreements (SLAs), quality benchmarks, and productivity goals. Ensure professional and effective communication with both clients and colleagues.    Candidate Requirements: Experience: 06m to 4 years in AR Calling / US Medical Billing / RCM. Excellent verbal communication skills in English. Willingness to work night shifts (aligned with US time zone). Basic knowledge of the US healthcare revenue cycle is an added advantage. Contact Immediately   Jyeshta  : 76191 85930Nihal     : 73384 44389Raj       : 98451 62196Anu      : 98450 43512Nithin   : 98869 64485Priya     : 76192 18164 Best Regards, Personal Network

Dear Candidate,   We are hiring Deputy Manager & Manager - Claim and Fraud Detection Salary upto 16 LPA The Manager Claims is responsible for maintaining the establishment of claims philosophy and procedures. The role is also responsible to ensure that the claims activities are well managed at the branch / hub; training of the vendors to ensure quality output; compliance to regulatory, IFIM & other internal guidelines; prepare periodic metrics on claims; implementation of the claims system; assessment and review of claims on an ongoing basis and team management within the Claims Function. Key Responsibility Areas Assessment of claims Claims Process and Procedure Leadership & Teamwork Operational Effectiveness & Control The role has to ensure that the processes and procedures are followed and implemented in such a way that there is a balance maintained between the emotions and the process to ensure that the image of the company is not tarnished. The job requires an eye for detail to fish out unique fraudulent cases. Decisions relate to the application of established procedures or the choice of alternative approaches.  Varied decision-making may require reasoned estimates based on an understanding of principles and a systematic search for the cause of events from a number of variables. Claims adjudication task in India is widespread and there is inconsistency in the way the death and the illness records are maintained Responsible to identify and prevent payment of fraudulent claims. Assess claims and ensure a periodic review of pending claims for expediting decisions. Monitor, generate, understand and interpret reports for various stakeholders.

JOB RESPONSIBILITIES: Applying medical knowledge in evaluating the medical claim files to ascertain the medical admissibility. Must understand the policy wordings including Terms && conditions to adjudicate theAdmissibility/Rejection.Processing of claims as per regulatory guidelines. Adhering to the TATs in processing.Quality review of processed files. Grievance redressal, handling escalations and identifying the fraudulent claims.

Hi We have an urgent opening for Assistant Manager for our company We are looking for an experienced and detail-oriented Assistant Manager Claims to join our Claims team. The ideal candidate will have 4-5 years of experience in insurance claims handling or operations, with strong expertise in managing insurer relationships, handling both reimbursement and cashless claims, and driving adherence to Turnaround Time (TAT) and Service Level Agreements (SLAs). Job Location is Noida Key Responsibilities: Insurer & Internal Query Management Act as the primary contact for insurer communications and internal support queries. Ensure timely resolution of escalations and claim-related issues. Claims Processing Reimbursement & Cashless Manage end-to-end processing of reimbursement claims, including documentation, validation, and settlement. Generate and send cashless debit notes to insurers and follow up for approvals and payments. Insurer Relationship Management Maintain strong working relationships with insurers (Health or General Insurance). Coordinate regularly to address claim-related issues and streamline processes. TAT Monitoring & SLA Compliance Monitor claims turnaround time (TAT) and ensure compliance with internal and external SLA benchmarks. Identify delays or inefficiencies and implement corrective actions to improve process efficiency. Reporting & Process Improvement Prepare regular reports on claims performance, TAT, and issue trends. Recommend and support initiatives for process enhancement and operational excellence. Experience & Qualifications: Experience: 4-5 years in Claims Handling or Insurance Operations Industry Background: Experience with Insurance Companies or Third Party Administrators (TPAs) preferred Exposure to Health or General Insurance is highly desirable Education: Bachelor's degree in any discipline (preferred: Insurance, Healthcare, or Business Administration) Skillset: In-depth knowledge of reimbursement and cashless claim processes Strong relationship management and coordination skills Familiarity with TAT and SLA monitoring Proficiency in MS Office and claims management systems Strong communication, analytical, and problem-solving skills. If you are interested you can share your resume to ankitarecruiter1103@gmail.com  Regards Ankita

Role Overview: You will be responsible for managing the entire claims settlement process from submission to final resolution. Your role will involve assessing claims, investigating their validity, coordinating with adjusters, and ensuring timely and fair settlements. It is essential for you to have a strong understanding of insurance policies, excellent negotiation skills, and adherence to company standards and legal regulations to succeed in this role. Key Responsibilities: - Handle the entire claims process, from reviewing submitted documentation to determining eligibility based on policy coverage. - Analyse data according to the provided SOPs (Standard Operating Procedures) to ensure accurate and efficient claim handling. - Conduct thorough investigations by collecting relevant data, conducting interviews, and working with adjusters and external experts to verify claim validity. - Keep policyholders and agents informed on the status of claims, provide clarity on coverage decisions, and guide them through the settlement process. - Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair, within policy limits, and compliant with legal standards. - Maintain detailed records of claims processing activities, including assessments, investigation reports, and settlement documentation. - Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary. - Ensure all claims are processed in adherence to company policies, industry regulations, and legal requirements. - Collaborate with the legal team on disputed claims or cases involving litigation to ensure proper handling. - Deliver exceptional customer service by addressing claim-related inquiries, resolving disputes, and ensuring a smooth claims experience for policyholders. - Recommend improvements to enhance efficiency and reduce claims processing time. Qualification Required: - Strong understanding of insurance policies, claims processes, and regulatory requirements. - Proven negotiation and conflict resolution skills. - Ability to analyze complex claims data for fair settlement decisions. - Strong communication skills, both verbal and written. - Attention to detail with excellent organizational abilities. - Ability to work independently and manage multiple claims simultaneously. Additional Details: Omit this section as there are no additional details of the company provided in the job description.,

As a Claims Processor at Intech Insurance Surveyors and Loss Assessors Pvt. Ltd., your role will involve various responsibilities to ensure efficient processing of claims. Your main duties will include: - Preparation of ILA, final survey reports, drafting letter of requirements, and other necessary reports. - Updating new intimations, survey visits, received & pending documents, and submission of reports in the register. - Following up with insured individuals for required documents and coordinating within the team to maintain minimum Turnaround Time (TAT). - Updating claims details in the CMS software. - Handling all other relevant back-office tasks. To be successful in this position, you must meet the following qualifications and requirements: - Experienced candidates should have prior experience in the insurance field. - Freshers interested in gaining exposure in the insurance industry are encouraged to apply. Any graduate with strong communication and report writing skills can apply. - Proficiency in Microsoft Word and Excel is necessary. - Local candidates are preferred for this role. - This position is open for female candidates only. In addition to competitive compensation based on skills and experience, you will be entitled to benefits such as health insurance and Provident Fund. This is a full-time, permanent position that requires in-person work at the specified location. If you are looking to join a dynamic team in the insurance sector and possess the required qualifications, we encourage you to apply for this role.,

As a Veterinary Insurance Claims Specialist at Quadrantech Pvt. Ltd., you will play a crucial role in the Claims Operations team. Your primary responsibility will be to review, validate, and process veterinary insurance claims with precision and attention to detail. Your expertise in veterinary terminology and strong analytical skills will be essential in ensuring compliance, accuracy, and quality customer service. Key Responsibilities: - Review and process veterinary insurance claims in adherence to company policies and service level agreements. - Evaluate clinical notes, treatment plans, invoices, and medical histories to determine claim validity. - Verify coverage eligibility, exclusions, and benefits before proceeding with claim adjudication. - Communicate effectively with veterinary clinics, pet owners, and internal teams to clarify any missing or unclear information. - Identify discrepancies, potential fraud indicators, and documentation gaps for further investigation. - Document claim decisions accurately and maintain records in the claim management systems. - Collaborate with QA, Operations, and Support teams to drive continuous process improvement initiatives. - Participate in daily standups, workflow reviews, and training sessions. - Ensure compliance with data protection and regulatory standards throughout the claims processing. Required Qualifications: - 02 years of experience in veterinary, medical, pet insurance, or healthcare claims processing. - Proficiency in veterinary medical terminology, procedures, and diagnostics. - Ability to interpret invoices, SOAP notes, treatment records, and lab reports effectively. - Strong familiarity with claims management systems and documentation tools. - Excellent analytical skills with a keen attention to detail. - Good working knowledge of MS Office applications such as Excel, Outlook, and Word. Soft Skills: - Excellent verbal and written communication skills. - Strong problem-solving and decision-making abilities. - Ability to work independently in a fast-paced environment. - Team-oriented mindset with effective collaboration skills. - Uphold a high level of accuracy, integrity, and professionalism in all tasks.,

Job Description You will be responsible for handling motor claims within the region, which includes processing motor OD claims files. You will interact with customers, investigators, surveyors, garage, and the marketing team to provide solutions in consultation. Your main tasks will be to maintain the Turnaround Time (TAT) of all claims and other parameters as per the guidelines, conduct ageing analysis of outstanding (OS) claims, prepare various Management Information System (MIS), complete open and closed file audits, and submit monthly and other periodical reports to the Team Leader. Key Responsibilities: - Handle motor claims within the region, including processing motor OD claims files - Interact with customers, investigators, surveyors, garage, and marketing team to provide solutions - Maintain TAT of all claims and other parameters as per guidelines - Conduct ageing analysis of OS claims - Prepare various MIS - Complete open and closed file audits - Submit monthly and other periodical reports as requested by Team Leader Qualifications Required: - B.tech/ Diploma in Automobile/Mechanical/Electrical & Electronics preferred - 0-3 years of experience Additional Details: No additional company details provided in the Job Description.,

Job Description: You will be responsible for handling insurance documentation, client coordination, and policy management to ensure smooth insurance operations. Key Responsibilities: - Process insurance applications, renewals, and claims. - Coordinate with clients, insurers, and internal teams. - Provide customer support and resolve insurance-related queries. Qualifications Required: - Graduate with experience in insurance operations or customer service. - Good communication and documentation skills. - Basic knowledge of general/life insurance policies preferred.,

Role Overview: You will be joining our dynamic medical billing team as a Claims Processing Executive (CPE). Your primary role will involve preparing, verifying, and retrieving medical records for US Workers Compensation claims. You will act as the main point of contact between our key clients and insurance companies, primarily through phone communication. Key Responsibilities: - Research, request, and acquire all relevant medical records and supporting documentation required for insurance claims processing, ensuring prompt and accurate claims reimbursement. - Prepare initial bill packets or appeal letters using Client systems tools and submit them with necessary documentation to insurance companies. - Perform any other duties as necessary. Qualifications Required: - Bachelor's Degree in any discipline. - Experience working in a US-based BPO or US healthcare insurance industry is preferred. - Proficiency in MS Office Suite and Windows applications. - Strong verbal communication skills. - Fast and accurate typing skills while engaging in conversations. - Ability to multitask data entry while communicating with clients and insurance companies. - Professional communication skills via phone, email, and fax. - Strong attention to detail while handling large work volumes in a fast-paced environment. - Ability to work under limited supervision, manage multiple tasks, and prioritize assignments within tight deadlines. - Effective communication of issues impacting project timelines. - Professional interaction at various organizational levels. - Timely and regular attendance. Please bring a hardcopy of your resume and dress in professional attire for the interview. The walk-in interview is scheduled for 20th November 2025, from 9:00 AM to 2:00 PM (IST) at Kavi India TES, PM Towers, 3rd floor, 37, Greams Rd, Thousand Lights West, Thousand Lights, Chennai, Tamil Nadu 600006. Note: This job is a full-time position and is open to both fresher candidates and experienced professionals. Food will be provided, and Provident Fund benefits are included. The work location is in person with a shift timing from 6:30 PM to 3:30 AM (IST).,

As a member of the medical insurance claims processing team, you will play a crucial role in verifying medical documents, liaising with hospitals, TPAs, and insurers, and ensuring the accurate and timely processing of claims. Your primary focus will be on documentation, coding/compliance, and effective communication. Key Responsibilities: - Review medical bills, treatment notes, and diagnostic reports to assess insurance claims. - Verify policy coverage, exclusions, and pre-authorizations to ensure accuracy. - Collaborate with TPAs, insurance companies, and hospital billing departments for seamless processing. - Ensure all claims are complete with necessary supporting documentation. - Handle queries, follow-ups, denials, and rejections efficiently. - Maintain records, meet SLAs, and adhere to turnaround times. - Provide medical expertise in reviewing treatment plans, coding, and clinical documentation to support claim adjudication. - Assist senior processing officers/managers as required. Qualifications: - MBBS degree holders (fresh graduates, house-surgeons preferred). - Proficiency in medical terminology, anatomy, and common diagnostics. - Strong written and verbal communication skills with keen attention to detail. - Basic computer skills including working with spreadsheets and claim processing software. - Ability to thrive in a fast-paced environment, manage multiple tasks, and meet deadlines. In addition to the responsibilities and qualifications mentioned above, the company offers competitive salary with incentives/performance bonuses, comprehensive training in insurance claims norms, coding, and policy review, regular working hours with occasional extended hours if necessary, and opportunities for career growth into senior processing or supervisory roles. Please note that this is a full-time position suitable for freshers.,

Role Overview: As a Claims end-end Deputy Manager, you will be responsible for reviewing and validating claims submissions, coordinating with various stakeholders, evaluating claim merits, determining liability, calculating claim amounts, ensuring adherence to internal SLAs and regulatory timelines, communicating claim decisions, maintaining documentation, analyzing claims trends, and contributing to claims automation and digitization initiatives. Your role will also involve collaborating with internal teams for resolution, driving customer satisfaction, and identifying process gaps for improvement. Key Responsibilities: - Review and validate claims submissions for completeness and eligibility. - Capture claim details accurately in the system, ensuring proper documentation. - Coordinate with policyholders, agents, or brokers to obtain necessary supporting documents. - Evaluate claim merits based on policy terms and conditions. - Liaise with surveyors, investigators, hospitals, or repair vendors for fact verification. - Identify potential cases of fraud or misrepresentation and escalate appropriately. - Determine liability and admissibility in line with underwriting guidelines. - Calculate claim amounts, applying sub-limits, deductibles, and exclusions where applicable. - Ensure adherence to internal SLAs and regulatory timelines. - Communicate claim decisions (approval/rejection) with clarity and empathy. - Maintain complete documentation for audit and compliance purposes. - Act as a single point of contact for claim-related queries and escalations. - Collaborate with internal teams (Underwriting, Legal, Finance, Customer Service) for resolution. - Drive customer satisfaction through proactive updates and transparent communication. - Ensure adherence to IRDAI and internal compliance policies. - Identify process gaps and contribute to claims automation and digitization initiatives. - Analyze claims trends to recommend improvements in risk management and policy design. Qualifications Required: - Excellent communication skills with 8+ years of work experience. - Strong knowledge of insurance claims (General Liabilities, Auto/Motor & Direct). - Individual contributor roles are acceptable. - Candidates with experience in Subrogation total loss, admin team, Property & Casualty, or Health Insurance are not preferred. (Note: Additional details of the company are not available in the provided job description.),

We are looking for an efficient Mortgage Loan Processor to process mortgage loan files and help clients submit complete applications. You will gather all necessary documentation and spot mistakes to ensure approval for the mortgage. If you want to succeed as a mortgage loan processor, you should be highly detail oriented. Customer service and communication skills are key since youll be the glue that binds all interested parties, from clients to underwriters. Mortgage loan processors should also have an aptitude in math and excellent time management skills. Responsibilities Perform a general evaluation of an application (financial documents, mortgage type etc.) Help client choose the most appropriate mortgage Gather all important data from client (assets, debts etc.) Verify information and references by contacting the right sources Correct mistakes and investigate inconsistencies Submit completed loan files for appraisal Act as point of contact between loan officers, underwriters and clients Conduct a final review of the file before closing

An executive claims management job description involves overseeing a team, managing claims operations from intake to settlement, and ensuring compliance with regulations. Key duties include strategic leadership, client communication, managing performance, and handling complex escalations, while also focusing on process improvement and team development.    Core responsibilities Team and operational leadership: Manage and lead a team of claims specialists or adjusters, including hiring, training, performance appraisals, and employee engagement. Oversee daily workflow, allocate resources, and balance workloads to meet operational KPIs and SLAs. Claims process management: Direct the entire claims lifecycle, from First Notice of Loss (FNOL) to adjudication and final settlement. Handle complex claims cases, disputes, and client escalations. Work with various stakeholders like insurers, adjusters, solicitors, and other departments. Compliance and quality assurance: Ensure all claims activities comply with relevant insurance laws, regulations, and internal policies. Monitor the quality of claims processing and ensure adherence to best practices. Client and stakeholder relations: Act as a primary point of contact for clients, managing relationships and resolving escalated issues. Collaborate with other departments to ensure seamless integration of claims operations with broader business objectives. Reporting and analysis: Prepare and present reports on key performance metrics, operational trends, and improvement opportunities. Implement solutions to enhance efficiency, accuracy, and service delivery. 

Job Description: As a full-time, permanent employee, you will be joining our team as a fresher in a dynamic work environment. Your role will involve the following key responsibilities: - Handling tasks related to Provident Fund Your qualifications should include: - Ability to work in person at the designated work location Please note that the additional details of the company are not provided in the job description.,

In this role at our company, you will be responsible for reviewing and processing claims related to Ayurvedic treatments and services. Your key responsibilities will include: - Verifying coverage and eligibility for Ayurvedic insurance policies. - Ensuring accurate documentation and compliance with regulatory standards. - Communicating with healthcare providers to obtain necessary information for claims processing. - Resolving discrepancies and issues related to claims in a timely manner. - Maintaining accurate records of processed claims and updates in the system. - Collaborating with the customer service team to address client inquiries about claims status. To qualify for this position, you should have: - Minimum of 2 years of experience in claims processing, specifically in Ayurvedic insurance or alternative medicine. - Experience working in a hospital setting, with an understanding of healthcare operations and patient care processes. - Strong understanding of insurance policies and claims regulations. - Excellent attention to detail and analytical skills. - Proficiency in claims processing software and Microsoft Office Suite. - Strong communication and interpersonal skills. - Ability to work independently and as part of a team.,

You will be responsible for overseeing operational activities, mentoring junior team members, and driving service excellence through data-driven insights and process improvements. Your key responsibilities will include: - Supporting and guiding junior team members in task execution and issue resolution - Monitoring and tracking operational KPIs and service-level metrics; generating periodic reports for leadership review - Collaborating with Claims handlers, adjusters, underwriters, and cross-functional teams to ensure timely and accurate processing - Ensuring compliance with regulatory guidelines and internal policies - Identifying process gaps and contributing to continuous improvement initiatives - Maintaining audit-ready documentation and supporting internal/external audits Desired Skills: - Strong understanding of insurance operations and end-to-end Claims workflows - Experience in mentoring or supervising team members - Proficiency in MS Office tools and reporting platforms; familiarity with Claims or policy administration systems - Analytical mindset with the ability to interpret data and drive insights - Excellent communication and stakeholder management skills - High level of professionalism and discretion in handling sensitive information Education / Experience: - Graduate in any discipline; insurance certifications preferred - 4+ years of experience in insurance operations, with a focus on Claims - Experience in KPI tracking, reporting, and team coordination - Willingness to work in night or afternoon shifts as required,

You are a skilled Veterinary Insurance Claims Specialist who will be joining the Claims Operations team at Quadrantech Pvt. Ltd. In this role, you will be responsible for reviewing, validating, and processing veterinary insurance claims with great attention to detail. Your analytical skills, knowledge of veterinary terminology, and ability to work collaboratively with global teams while ensuring compliance and service-level standards are crucial for success in this position. Key Responsibilities: - Review and process veterinary insurance claims in accordance with company policies and SLAs - Evaluate clinical notes, treatment plans, invoices, and medical histories to determine claim validity - Verify coverage eligibility, exclusions, and benefits prior to claim adjudication - Communicate with veterinary clinics, pet owners, and internal teams to address missing or unclear information - Identify discrepancies, potential fraud indicators, and documentation gaps - Document claim decisions accurately and maintain records in claim management systems - Collaborate with QA, Operations, and Support teams to drive continuous process improvement - Participate in daily standups, workflow reviews, and training sessions - Ensure compliance with data protection and regulatory standards Required Qualifications: - Experience in veterinary, medical, pet insurance, or healthcare claims processing - Strong understanding of veterinary medical terminology, procedures, and diagnostics - Ability to interpret invoices, SOAP notes, treatment records, and lab reports - Proficiency with claims management systems and documentation tools - Strong analytical skills with excellent attention to detail - Good working knowledge of MS Office (Excel, Outlook, Word) Preferred Qualifications: - Experience with US/UK/AUS insurance processes - Familiarity with claim adjudication guidelines and regulatory compliance - Exposure to workflow tools like CRM platforms, ticketing systems, or BPM tools - Knowledge of denial management, appeals, and resubmission processes Soft Skills: - Excellent verbal and written communication skills - Strong problem-solving and decision-making abilities - Ability to work independently and thrive in a fast-paced environment - Team-oriented mindset with strong collaboration skills - High level of accuracy, integrity, and professionalism,