claim-processor-jobs-in-nashik, Nashik

4 Claim Processor Jobs nearby Nashik

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posted 2 months ago

Contract Engineer

Ashoka Buildcon Limited
experience5 to 9 Yrs
location
Nashik, Maharashtra
skills
  • Contract Management
  • Contract Administration
  • Record keeping
  • Interpreting contractual conditions
  • Preparation of Contract Appreciation Documents
  • Monitoring contractual communications
  • Drafting correspondences
  • Submission of claims
  • Participating in meetingsdiscussions
  • Handling contractual correspondence
  • Preparation of Monthly Progress Report
  • Tracking reporting progress
  • Identifying disputes
  • Proficient in MS Office
  • Excellent communication skills
  • Excellent documentation skills
  • Quick analysis
Job Description
As a Contract Manager at our company, your role will involve the following responsibilities: - Responsible for Contract Management and Contract Administration post award of the project. - Coordinating, interacting with, and guiding project team and various departments on contractual conditions. - Studying Contract documents and interpreting contractual conditions. - Highlighting roles, responsibilities, obligations, and rights under the contract. - Preparation of Contract Appreciation Documents (CAD), Key points, and salient features of contracts. - Monitoring contractual communications by tracking day-to-day project correspondences. - Drafting and communicating correspondences in perspective of contract provisions. - Maintaining comprehensive record keeping of correspondences and contractual reports & data. - Notifying variation/change of scope and taking actions accordingly using available resources. - Preparation, reviewing, and submission of claims like Extension of time claim, cost claims such as non-productiveness of Manpower & Machinery, loss of opportunity, overheads. - Participating in meetings/discussions for finalization of claims, disputes, progress apprehensions, and other contractual matters. - Handling contractual correspondence with Clients & subcontractors. - Regular administration of contractual matters and follow-ups. - Preparation and drafting of various submissions in Arbitration proceedings, dispute resolution proceedings, Conciliations, and legal proceedings. - Preparation of Monthly Progress Report for the project. - Tracking & reporting progress of work of subcontractor based on milestone & cash flow set-forth in the contract. - Identifying disputes arisen in the contract during the execution of the project and prepare a list of events of delays and statement of probable claims. - Recording facts of the case and event calendar. Qualifications required for this role: - B.E./B.Tech.(Civil) and Post Graduation (NICMAR). In addition, the ideal candidate should possess the following skills: - Proficient in MS Office (Word, Excel, PowerPoint). - Excellent communication and documentation skills. - Quick to analyze, extract, and act on critical contractual information.,
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posted 1 month ago
experience2 to 6 Yrs
location
Nashik, Maharashtra
skills
  • Insurance
  • Finance skills
  • Consulting
  • Customer Service skills
  • Excellent Communication skills
  • Strong organizational
  • recordkeeping skills
Job Description
**Job Description** As a Motor Insurance Advisor at Shreya Cars in Nasik, your role will involve providing insurance consulting services to customers. This includes assisting customers with insurance policy selection, processing insurance claims, and maintaining accurate records. Your responsibilities will also include building and nurturing customer relationships, delivering exceptional customer service, and effectively communicating with clients to address their insurance-related requirements. **Key Responsibilities** - Provide insurance consulting services to customers - Assist customers with insurance policy selection - Process insurance claims efficiently - Maintain up-to-date and accurate records - Build and maintain strong customer relationships - Deliver excellent customer service - Communicate effectively with clients to address their insurance needs **Qualifications Required** - Possess Insurance and Finance skills - Demonstrate Consulting and Customer Service skills - Have Excellent Communication skills - Strong organizational and record-keeping abilities - Bachelor's degree in Finance, Insurance, Business Administration, or related field preferred - Previous experience in motor insurance and customer service is advantageous - Ability to work both independently and as part of a team,
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posted 2 weeks ago
experience4 to 8 Yrs
location
Nashik, Maharashtra
skills
  • control systems design
  • single line diagrams
  • regulatory requirements
  • electrical testing
  • troubleshooting
  • fieldbus
  • PLC
  • manufacturing processes
  • analytical skills
  • communication skills
  • wiring schematics
  • Bill of Materials BOM
  • ECAD tools
  • Power Heat load Calculations
  • revision control
  • assembly plan
  • integration progress monitoring
  • Factory Acceptance Testing FAT
  • validation of control systems
  • industrial communication protocols
  • safety
  • compliance standards
  • HMI knowledge
  • documentation skills
  • problemsolving skills
Job Description
As a Hardware Design Engineer at Emerson, you will play a crucial role in designing and developing hardware for control systems. Your responsibilities will include: - Creating general arrangement drawings, wiring schematics, and single line diagrams for control systems - Selecting appropriate components such as relays, power supplies, I/O modules, processors, and barriers based on customer specifications - Preparing Bill of Materials (BOM), cross wiring databases, and loop typical drawings using E-CAD tools like AutoCAD Electrical - Conducting Power & Heat load Calculations to determine power and cooling requirements of a cabinet - Ensuring designs meet performance, safety, and regulatory requirements (IEC, UL, CE, etc.) - Submitting deliverables for customer review, implementing corrections based on feedback - Maintaining revision control of hardware deliverables for final as-built preparation and compliance audits - Optimizing designs by utilizing readily available stock from stores - Collaborating with counterparts in different world areas to provide dynamic solutions to project challenges - Coordinating with buyers to ensure timely ordering of project materials - Resolving discrepancies between design documents and build conditions during cabinet assembly - Monitoring integration progress, maintaining timelines, and ensuring build quality and compliance - Conducting periodic progress calls with stakeholders to review project status and address queries - Assessing and raising risks in a timely manner - Supporting Factory Acceptance Testing (FAT) and ensuring systems are tested per project specifications - Collaborating with QA/QC teams to address integration-related non-conformities Qualifications required for this role include: - Diploma or Bachelor's degree in Electrical or Instrumentation Engineering - 3-6 years of experience in control panel integration, PLC cabinet assembly, or industrial automation projects - Strong knowledge of control panel components, power circuits, protection devices, PLCs, and industrial communication protocols - Ability to read and interpret electrical schematics and panel GA/layout drawings - Hands-on experience with EDA/E-CAD tools like AutoCAD Electrical or EPLAN - Experience in electrical testing, troubleshooting, and validation of control systems Preferred skills for this role include experience with fieldbus and industrial communication protocols, familiarity with safety and compliance standards, basic PLC or HMI knowledge, and knowledge of manufacturing processes for control panels and PCB assemblies. Emerson is committed to creating a global workplace that supports diversity, equity, and inclusion. We offer competitive compensation and benefits programs, comprehensive medical and insurance coverage, and opportunities for career development. Our Remote Work Policy promotes work-life balance through a hybrid work setup. Safety is paramount to us, and we strive to provide a safe working environment across our global network and facilities. At Emerson, we value diversity and inclusion as essential components of our culture. We are dedicated to fostering a work environment where every employee is respected for their unique experiences and perspectives. If you have a disability and require assistance in applying for a position, please contact idisability.administrator@emerson.com. Join us at Emerson and be part of a collaborative community that drives innovation to make the world healthier, safer, and more sustainable. Together, we can create a positive impact across industries and countries. Let's go!,
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posted 3 weeks ago

Sales Expert

Finkasha Services Private Limited
experience0 to 3 Yrs
location
Nashik, Maharashtra
skills
  • Customer Service
  • Lead Generation
  • Analytical Skills
  • Excellent Communication
  • Sales Closing Management
  • Organizational Skills
Job Description
In Finkasha Services Private Limited (FSPL), we are dedicated to empowering individuals and businesses to achieve financial confidence by offering tailored, transparent, and ethical financial guidance. As a Sales Specialist located in Nashik, your role will involve developing lead generation strategies, maintaining customer relationships, providing exceptional customer service, and achieving sales targets. **Roles and Responsibilities:** - Generate leads and identify potential clients for insurance products. - Conduct client meetings to assess needs and recommend suitable products. - Provide clear explanations of product options and benefits to clients. - Close sales and ensure proper documentation. - Follow up with clients for after-sales service. - Build and maintain long-term relationships with clients. - Meet and exceed monthly and annual sales targets. - Stay updated on financial services new products, industry regulations, and market trends. - Provide after-sales support and assist clients with claims and queries. - Cross-sell products based on client demand. **Skills:** - Excellent Communication and Customer Service skills. - Proficiency in Lead Generation tactics. - Proven experience in Sales and Sales Closing Management. - Strong organizational and analytical skills. - Ability to work independently and as part of a team. **Eligibility:** - Fresher to 2 years of experience in product sales in a related industry. - Post Graduation / Graduation degree in Business, Finance, or Marketing. Join us at Finkasha to contribute to our mission of putting Clients" Goals First and to be a part of a dynamic team dedicated to financial empowerment.,
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posted 3 days ago
experience2 to 6 Yrs
location
Maharashtra
skills
  • Data analysis
  • Client communication
  • Fraud detection
  • Compliance
  • Customer service
  • Insurance claims handling
  • Settlement negotiation
  • Documentation reporting
Job Description
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.,
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posted 2 weeks ago
experience2 to 6 Yrs
location
Pune, All India
skills
  • Customer Service
  • Claims Processing
  • Analytical Skills
  • Communication Skills
  • Interpersonal Skills
  • Insurance Domain
  • Property
  • Casualty Insurance
Job Description
As an SPE-Ins Claims at our company, you will be responsible for managing insurance claims efficiently, providing exceptional customer service, and ensuring compliance with industry regulations and company policies. Your expertise in property and casualty insurance will play a crucial role in enhancing claim processing accuracy and client satisfaction. **Key Responsibilities:** - Manage and process insurance claims to ensure timely resolution and customer satisfaction. - Collaborate with cross-functional teams to gather necessary information for claim assessments. - Analyze claim data to identify trends and improve service delivery. - Provide exceptional customer service by addressing inquiries and resolving issues promptly. - Utilize domain knowledge in property and casualty insurance to enhance claim processing accuracy. - Implement best practices in claims management to optimize workflow and reduce processing time. - Develop and maintain strong relationships with clients to foster trust and loyalty. - Ensure compliance with industry regulations and company policies during claims processing. - Monitor and report on claim status and outcomes to stakeholders regularly. - Participate in training sessions to stay updated on industry trends and technologies. - Support team members in achieving collective goals and improving overall performance. - Adapt to rotational shifts and hybrid work model effectively to meet business needs. **Qualifications:** - Possess strong customer service skills with a focus on insurance domain expertise. - Demonstrate proficiency in property and casualty insurance processes. - Exhibit excellent communication and interpersonal skills for client interactions. - Show ability to work in a hybrid model with rotational shifts. - Display analytical skills for assessing claim data and improving service delivery. - Have experience in managing and processing insurance claims efficiently. - Maintain knowledge of industry regulations and compliance requirements. This role requires a Certified Insurance Service Representative (CISR) or equivalent certification in insurance claims to ensure you meet the necessary qualifications for the position. As an SPE-Ins Claims at our company, you will be responsible for managing insurance claims efficiently, providing exceptional customer service, and ensuring compliance with industry regulations and company policies. Your expertise in property and casualty insurance will play a crucial role in enhancing claim processing accuracy and client satisfaction. **Key Responsibilities:** - Manage and process insurance claims to ensure timely resolution and customer satisfaction. - Collaborate with cross-functional teams to gather necessary information for claim assessments. - Analyze claim data to identify trends and improve service delivery. - Provide exceptional customer service by addressing inquiries and resolving issues promptly. - Utilize domain knowledge in property and casualty insurance to enhance claim processing accuracy. - Implement best practices in claims management to optimize workflow and reduce processing time. - Develop and maintain strong relationships with clients to foster trust and loyalty. - Ensure compliance with industry regulations and company policies during claims processing. - Monitor and report on claim status and outcomes to stakeholders regularly. - Participate in training sessions to stay updated on industry trends and technologies. - Support team members in achieving collective goals and improving overall performance. - Adapt to rotational shifts and hybrid work model effectively to meet business needs. **Qualifications:** - Possess strong customer service skills with a focus on insurance domain expertise. - Demonstrate proficiency in property and casualty insurance processes. - Exhibit excellent communication and interpersonal skills for client interactions. - Show ability to work in a hybrid model with rotational shifts. - Display analytical skills for assessing claim data and improving service delivery. - Have experience in managing and processing insurance claims efficiently. - Maintain knowledge of industry regulations and compliance requirements. This role requires a Certified Insurance Service Representative (CISR) or equivalent certification in insurance claims to ensure you meet the necessary qualifications for the position.
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posted 1 week ago
experience5 to 9 Yrs
location
Pune, Maharashtra
skills
  • Leadership Skills
  • Analytical Skills
  • Communication Skills
  • Project Management
  • Insurance Expertise
  • Innovation
  • Improvement
Job Description
As a (Senior) Claims Specialist and Product Owner at Global Organization, India, you will play a pivotal role in bridging the gap between strategic initiatives and operational execution in the insurance market. Collaborating with a diverse team of Claims Specialists, Product Owners, Product Managers, and Business Analysts, you will drive innovation and excellence in claims management and product development. Key Responsibilities: - **Product Ownership:** Take full ownership of the Product Claims feature team, ensuring alignment with strategic goals and market needs specific to the Indian insurance sector. You will prioritize work items that align with business objectives and deliver value to customers through quality epics and user stories with clearly defined acceptance criteria. - **Strategic Initiatives:** Work under the guidance of senior colleagues to support the development and execution of strategic initiatives tailored to the Indian insurance landscape. - **Product Vision and Advocacy:** Build consensus for the product vision internally and externally, serving as the ambassador for the BMP product area within the Indian market context. - **System Integration:** Guide the team in implementing requirements that connect core systems like OPUS, BMP, and third-party systems, ensuring seamless integration and functionality. - **Project Management:** Communicate project objectives, plan timelines, and allocate resources effectively to meet the unique demands of the insurance market. - **Operational Excellence:** Contribute to operational processes against agreed standards and timelines, supporting continuous improvement through innovation and excellence in claims management. - **Backlog Management:** Manage the backlog by planning work and overseeing committed epics to ensure alignment with market needs and business objectives. - **End-to-End Process Understanding:** Understand requirements in the context of end-to-end processes, tailoring them to the specific dynamics of the insurance market. - **Collaborative Action:** Support management colleagues in collaborative actions and teamwork where interdependencies demand cooperation, fostering a culture of shared success. What You'll Bring to the Role: - **Insurance Expertise:** Strong knowledge of the Indian insurance market, including regulatory environment, customer behavior, and industry trends. - **Leadership Skills:** Proven ability to lead cross-functional teams and drive consensus among diverse stakeholders. - **Analytical Skills:** Strong analytical and problem-solving skills to translate complex requirements into actionable plans. - **Communication Skills:** Excellent written and verbal communication skills to articulate complex concepts to diverse audiences. - **Project Management:** Experience in managing projects with a focus on timelines, resource allocation, and strategic alignment. - **Innovation and Improvement:** Proactive approach to continuous improvement, focusing on innovation and excellence in claims management.,
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posted 3 weeks ago

Claims Processing (Day Shift)

INTEGRUM OUTSOURCE SOLUTIONS PVT LTD
experience1 to 5 Yrs
location
Navi Mumbai, Maharashtra
skills
  • medical billing
  • Microsoft Word
  • Excel
  • US Health insurance claim processing
  • coding terminologies
Job Description
As a candidate for this role, you should possess U.S. Health insurance claim processing experience and have knowledge of medical billing and coding terminologies. You must be willing to work in both Night Shift and Day shift. Your role will involve understanding plan documents and general benefits, with a strong emphasis on attention to detail and accuracy. Additionally, you should be proficient in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, and guidelines, as well as state and federal regulations during the claim process - Review claims to determine the reasonableness and medical necessity of costs - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Protect operations by maintaining confidentiality of claims information and being HIPPAA compliant - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general and administrative duties as assigned Qualifications Required: - 1 year of experience in US Health Insurance - Location requirement: Navi Mumbai, Maharashtra - Shift availability: Night Shift and Day Shift - Work Location: In-person Please note: This role involves working with sensitive information and requires strict adherence to legal compliance and confidentiality standards. Your ability to analyze, problem-solve, and adapt to changing workflows will be key to success in this position.,
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posted 2 months ago

Contracts and Claims Manager

KALPATARU PROJECTS INTERNATIONAL LIMITED
experience5 to 10 Yrs
location
Maharashtra
skills
  • Contract Administration
  • Claims Management
  • Dispute Resolution
  • Interpersonal Skills
  • Oil Gas Construction Projects
  • Contractual Compliance
  • Claims Preparation
  • Extension of Time EOT Requests
  • Delay Management
  • Subcontractors Performance Monitoring
  • Excellent Communication
Job Description
Role Overview: You will be responsible for overseeing main contracts and subcontracts, ensuring contractual compliance, managing claims, preparing, managing and logging all correspondences, issuing necessary notices, preparing claims, variation and Extra Work claims, Extension of Time (EOT) requests, handling delay management, managing dispute resolution, and monitoring subcontractors" performance to ensure compliance and meeting timelines. Key Responsibilities: - Oversee main contract and subcontracts, ensuring contractual compliance and managing claims - Prepare, manage and log all correspondences and issuing necessary notices - Prepare claims, variation and Extra Work claims - Prepare Extension of Time (EOT) requests and handle delay management - Manage dispute resolution - Monitor subcontractors" performance and ensure compliance and meeting timelines Qualification Required: - Graduate Mechanical Engineer Additional Details: Kalpataru Projects International Ltd. is looking for a candidate with a minimum of 10+ years of experience, ideally with a minimum of five years in handling contract administration and claims management of Oil & Gas construction projects. The ideal candidate should also possess the competency of Adaptability/Flexibility and skills in excellent communication and interpersonal interactions.,
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posted 2 weeks ago

Claims Processing (Day Shift) - Only Freshers

INTEGRUM OUTSOURCE SOLUTIONS PVT LTD
experience1 to 5 Yrs
location
Navi Mumbai, All India
skills
  • medical billing
  • Microsoft Word
  • Excel
  • US Health insurance claim processing
  • coding terminologies
Job Description
As a candidate for this position, you should possess experience in U.S. health insurance claim processing and have knowledge of medical billing and coding terminologies. You should be willing to work in both night and day shifts. Your role will involve understanding plan documents and general benefits, demonstrating strong attention to detail and accuracy, and being proficient in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, state, and federal regulations during the claim process - Review claims to determine the reasonableness and medical necessity of costs - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Keep claims information confidential and maintain HIPPAA compliance - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general administrative duties as assigned Qualifications Required: - 1 year of experience in U.S. Health Insurance - Location: Navi Mumbai, Maharashtra - Availability for both Night Shift and Day Shift - Work Location: In person Please note that this is a full-time position that requires you to be detail-oriented, analytical, and knowledgeable in the field of health insurance claim processing. As a candidate for this position, you should possess experience in U.S. health insurance claim processing and have knowledge of medical billing and coding terminologies. You should be willing to work in both night and day shifts. Your role will involve understanding plan documents and general benefits, demonstrating strong attention to detail and accuracy, and being proficient in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, state, and federal regulations during the claim process - Review claims to determine the reasonableness and medical necessity of costs - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Keep claims information confidential and maintain HIPPAA compliance - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general administrative duties as assigned Qualifications Required: - 1 year of experience in U.S. Health Insurance - Location: Navi Mumbai, Maharashtra - Availability for both Night Shift and Day Shift - Work Location: In person Please note that this is a full-time position that requires you to be detail-oriented, analytical, and knowledgeable in the field of health insurance claim processing.
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posted 3 weeks ago
experience3 to 7 Yrs
location
Maharashtra
skills
  • Health Insurance
  • Team leadership
  • Compliance
  • Regulatory requirements
  • Medical decisioning
  • Claim processing management
  • Fraud restriction
  • Clinical knowledge
  • Digital tools
Job Description
In this role as an Assistant Manager Claims Management with the Prudential Health India team in Mumbai, your responsibilities will include: - Guiding the TPA processing team by providing medical opinion for Health Insurance Claims - Ensuring that claims are settled validly according to company practices and procedures - Processing and approving medical claims for both Group and Retail, focusing on sharp FWA and Loss minimization approaches - Maintaining thorough knowledge of compliance and regulatory requirements, and implementing them in the claims process - Managing potential cases by referring them to the Network team, tracking data of referrals/savings achieved/impact against cashless outgo - Implementing automation and rule-driven decision-making for timely benefit updates - Creating and reviewing claim simplification guidelines to improve TAT and minimize transactions - Providing medical decisioning and guidance to the team - Auditing TPA processed claims and in-house processed claims - Ensuring regulatory compliance in claim processing guidelines and timely implementation of any new circular - Conducting timely training of TPA teams for new benefits, process changes, and understanding claim philosophy as per PHI standard - Collaborating with the FWA Manager to provide inputs for efficient fraud restriction and checks and balances in the system - Providing re-underwriting opinion for non-disclosure cases and training the team for indicated cases - Extending support to the sales/distribution with separate prioritization queues - Setting up and creating robust governance to manage the TPA process efficiently - Demonstrating proficiency with medical terms and systems, including ICD/CPT/PCS codes Qualifications for this role: - Doctor by training (BAMS/BHMS/BDS) - 03-05 years of experience in health insurance claim processing management, with at least 1-2 years as a team leader - Understanding of the TPA ecosystem and experience in managing the TPA model (Preferred) - Startup experience or setting up a team from scratch (Preferred but not mandatory) - Decisive and creative individual with quick decision-making abilities, good judgment, and analytical skills - Excellent verbal and written communication skills, as well as strong negotiation skills - Open to embracing change and managing it effectively If you are passionate about consumer behavior and culture, enjoy understanding customer needs, like working in a collaborative culture, and are dedicated to delivering exceptional customer experiences, this role might be the right fit for you. Location: Mumbai,
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posted 2 months ago
experience8 to 12 Yrs
location
Maharashtra
skills
  • Claims
  • Underwriting
  • Fraud Detection
  • Data Analysis
  • Stakeholder Engagement
  • Negotiation
  • Leadership
  • Process Management
  • Loss Ratio Analysis
  • Empathy
Job Description
As Chief Manager in the Risk, Underwriting & Claims department at Mumbai location, reporting to the Head of Risk, your role involves monitoring the risk performance of the portfolio, predicting fraud detection, and deriving strategies to reduce the Loss Ratio. Your responsibilities include: - Calculating, monitoring, and publishing the claim ratio dashboard - Providing insights on loss ratios, risk dynamics, and their impact on business performance - Executing LIVE tracking of claim ratios through automated Dashboards - Devising strategies to lower the Loss ratios and partnering with Internal Stakeholders for execution - Building a fraudulent insights team leveraging data to provide product/process solutions - Working with the tech team and settlement team to automate settlement APIs with Insurers - Formalizing strategies to migrate risk on One Assists books to Insurer You should have 8+ years of experience in Claims/Underwriting, with Motor underwriting as a bonus. An MBA will be an added advantage. Your skills and competencies should include engaging with Stakeholders across levels, strong negotiation skills, high levels of empathy and good listening skills, strong leadership skills in team management, and highly skilled in process management with attention to detailing. As a Chief Manager, you are expected to be a Go-Getter and self-starter with a bias for action, execution, and speed. You should be open to ideas, eager to experiment, and have a collaborative approach with ease in dealing with multiple stakeholders and teams.,
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posted 2 months ago

Health Claim Manager

Hakani Bimasolutions Insurance Brokers LLP
experience2 to 6 Yrs
location
Maharashtra
skills
  • Claims Handling
  • Claims Management
  • Analytical Skills
  • Communication Skills
  • Interpersonal Skills
  • Insurance Industry Knowledge
Job Description
Role Overview: You will be joining Hakani Bimasolutions Insurance Brokers as a full-time Health Claim Manager based in Mumbai (ANDHERI). Your main responsibilities will include claims handling, claims management, and utilizing your strong analytical skills to process insurance claims efficiently and accurately. Key Responsibilities: - Handle insurance claims effectively - Manage the entire claims process - Utilize analytical skills to process claims accurately Qualification Required: - Proficiency in claims handling and claims management - Strong analytical skills - Prior experience in the insurance industry - Knowledge of insurance claims processes - Excellent communication and interpersonal skills - Bachelor's degree in a relevant field,
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posted 2 months ago

Claims Manager-A&H

Liberty General Insurance
experience7 to 11 Yrs
location
Thane, Maharashtra
skills
  • General Insurance
  • Audit
  • Interpersonal skills
  • Analytical skills
  • Communication skills
  • Negotiation skills
  • Microsoft Excel
  • Accident Health claims
  • Medical cases
  • Policy coverages
Job Description
Role Overview: You will be responsible for conducting closed file review and audits, both for third party administrators and in-house claims processing. Your duties will include identifying areas for improvement, recovering funds from third party administrators for error-prone claims, and generating monthly reports. Key Responsibilities: - Conduct closed and open file reviews for third party administrators and in-house claims - Identify and recover funds from third party administrators for claims processed with errors - Highlight areas for improvement in the claims processing workflow - Publish monthly reports summarizing audit findings Qualification Required: - Degree in medicine (BHMS/BAMS/MBBS) - Minimum 7 years of experience in general insurance Accident & Health claims - In-depth knowledge of medical cases and policy coverages for OPD, hospitalization, personal accident, and travel claims - Previous experience in audit - Good interpersonal skills - Proactive and effective learner - Good analytical, communication, and negotiation skills - Familiarity with Basic Microsoft Excel and regulatory changes,
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posted 2 weeks ago

Claims Assessor

Jaguar Land Rover India
experience3 to 15 Yrs
location
Maharashtra
skills
  • Technical knowledge
  • Assessing warranty claims
  • Coordinating with National Sales Companies Importers
  • Identifying
  • highlighting issues with business rules
  • Quality Checks
  • Service Maintenance Plan administration
  • No Material Return technical review
  • Clear
  • effective communication
  • Team player
  • European automotive experience
  • Vehicle diagnosis
  • repair
  • Understanding of vehicle wiring diagrams
  • Understanding of vehicle communication networks
  • Microsoft Office skills
Job Description
In this role, you will be responsible for creating and providing Warranty Compliance & Procedures that integrate with claim submission and enquiry systems. Your targeted claim assessment skills will allow you to strategically select warranty claims to support key work streams and deliver commercial effectiveness. You will interface with retailers, National Sales Companies, export markets, and Regional Offices to ensure accurate and timely processing of warranty and goodwill claims. Through data interrogation, you will support various internal groups in investigating warranty costs to maintain control. Your key responsibilities will include: - Using your technical knowledge to assess warranty claims submitted to JLR and selected for review - Assessing appealed warranty claims that have been paid or rejected - Coordinating with National Sales Companies / Importers regarding warranty claim issues - Identifying and highlighting any business rule issues that require investigation or creation by the UK team while reviewing claims - Participating in regular meetings with the primary assessment team to monitor performance - Assisting in various functions such as Quality Checks, Service Maintenance Plan administration, and No Material Return technical review As for qualifications, we are looking for professionals with 3 to 15 years of experience across multiple openings for Claims Assessors ranging from entry-level to senior positions. You should be process-oriented with great attention to detail, able to manage time effectively to meet tight deadlines, and adapt quickly to changing circumstances and working instructions. Clear and effective communication skills are essential for assessing claims and contacting markets. Being a team player is crucial, along with being a minimum Level 2/Level 3 Technician with 3 to 5 years of European automotive experience. Additionally, you should be technically competent with a clear understanding of vehicle diagnosis and repair on both mechanical and electrical vehicle systems. Knowledge of PHEV/HEV/BEV system diagnosis and repair is desirable, along with the ability to read and understand vehicle wiring diagrams and vehicle communication networks. JLR product knowledge and experience would be advantageous, and proficiency in Microsoft Office skills is essential.,
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posted 4 weeks ago

Mortgage Loan Processor

ODH DEVELOPERS PRIVATE LIMITED
ODH DEVELOPERS PRIVATE LIMITED
experience12 to 20 Yrs
location
Pune, Qatar+16

Qatar, Kuwait, Noida, Tiruchengode, Chennai, Nepal, Hyderabad, Gurugram, Malaysia, Kolkata, Mussoorie, Mumbai City, Jordan, Ghana, Delhi, Kenya, Egypt

skills
  • budgeting
  • leadership
  • problem
  • management
  • communication
  • time
  • solving
  • organizational
  • skills
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
posted 2 months ago

Executive Claims Management

AWINMO INDIA MARKETING PRIVATE LIMITED
experience7 to 12 Yrs
Salary50 - 80 LPA
location
Pune, Maharashtra+8

Maharashtra, Chennai, Ramanathapuram, Tamil Nadu, Hyderabad, Sant Ravidas Nagar, Pondicherry, Purba Medinipur, Punjab

skills
  • processing
  • problem
  • claims
  • negotiation
  • service
  • customer
  • communication
  • solving
Job Description
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. 
posted 1 week ago
experience3 to 7 Yrs
location
Maharashtra
skills
  • Claims processing
  • Leadership
  • Employee management
  • Back office operations management
  • Technical expertise
  • Underwriting management
  • Internal relationship management
Job Description
Job Description: You will play a crucial role as Deputy Manager - Investigation Claims by providing back office operations management and technical expertise to oversee Underwriting and support Claims processing. Your responsibilities will include leadership of employees and internal relationship management. Key Responsibilities: - Manage back office operations related to Underwriting and Claims processing - Provide technical expertise to support investigations in Claims processing - Lead and supervise employees in their tasks - Manage internal relationships effectively Qualification Required: - Previous experience in Insurance operations management is preferred - Strong analytical and problem-solving skills - Excellent leadership and communication abilities To apply for this position, click "Apply" and follow the step-by-step process. Please note that QBE is an equal opportunity employer and is committed to complying with equal employment opportunity legislation in all jurisdictions it operates.,
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posted 1 month ago

PE-Ins Claims

Cognizant
experience2 to 6 Yrs
location
Pune, Maharashtra
skills
  • Customer Service
  • Claims Processing
  • Analytical Skills
  • Record Keeping
  • Process Improvement
  • Communication Skills
  • Compliance
  • Interpersonal Skills
  • Domain Knowledge
  • ProblemSolving
Job Description
As a PE-Ins Claims specialist, you will play a crucial role in enhancing claims processing efficiency in the Property & Casualty Insurance sector. Your customer service skills and domain knowledge will be pivotal in ensuring timely resolution of insurance claims and maintaining high customer satisfaction levels. **Key Responsibilities:** - Assist in processing insurance claims efficiently to ensure timely resolution and customer satisfaction. - Collaborate with team members to analyze and verify claim information for accuracy and completeness. - Utilize customer service skills to address inquiries and provide clear information to clients regarding their claims. - Support the team in maintaining accurate records of claims and related documentation. - Contribute to the development of process improvements to enhance claims processing efficiency. - Participate in training sessions to stay updated on industry trends and company policies. - Work closely with the Property & Casualty Insurance domain to understand specific claim requirements. - Engage in rotational shifts to provide consistent support and coverage for claim processing. - Communicate effectively with clients and stakeholders to ensure a smooth claims experience. - Apply domain knowledge to identify potential issues and escalate them appropriately. - Provide feedback to management on customer service improvements and claim processing enhancements. - Ensure compliance with company policies and industry regulations in all claim handling activities. - Foster a collaborative work environment to achieve team goals and improve service delivery. **Qualifications:** - Demonstrate strong customer service skills with a focus on client satisfaction. - Possess basic understanding of the Property & Casualty Insurance domain. - Exhibit excellent communication and interpersonal skills. - Show ability to work effectively in a hybrid work model and rotational shifts. - Display attention to detail and accuracy in claim processing. - Have a proactive approach to problem-solving and process improvement. The job also requires the following certifications: - Customer Service Certification - Property & Casualty Insurance Certification,
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posted 2 months ago
experience15 to 19 Yrs
location
Maharashtra
skills
  • Product Development
  • Cost Reduction Initiatives
  • Marketing
  • AGILE Methodologies
  • Innovation
  • Relationship Building
  • Safety Management
  • Compliance
  • Budget Planning
  • Resource Planning
  • Claims Development
  • Formulations
  • Performance Claims
  • Motorcycles Market
Job Description
Role Overview: You will be responsible for leading a team of technologists in India and Asia Pacific to deliver product and claims development for engine oil products across cars, motorcycles, and commercial vehicles. Your role will involve collaborating with business customers, developing new formulations, demonstrating performance claims, and driving cost reduction initiatives. Additionally, you will focus on the Motorcycles market space, working closely with marketing units to shape future product specifications and benefits. Key Responsibilities: - Build and mentor a technology team to deliver product and claims development pipeline for Castrol business - Collaborate with performance units and global marketing to influence future project portfolios - Lead technology projects within a changing external environment, using data-based decision making and creative solutions - Drive excellence in product development projects through matrixed teams and AGILE methodologies - Develop data to support technically-led claims and marketing performance claims - Ensure technically-led claims meet advertising standards and local legislation - Seek innovation for differentiation in the Castrol portfolio by building relationships with global and local marketing teams - Integrate digital ecosystem processes and balance product differentiation with cost considerations - Influence cross-functional stakeholders in complex situations to support technology delivery for global motorcycles growth - Build relationships with additive and base oil suppliers, representing BP's engine oil product technology to OEMs - Handle safety and operational risks according to BP's processes and performance metrics - Lead, develop, and mentor team members while ensuring compliance with BP's code of conduct - Ensure all projects meet lubricants technology quality and compliance standards - Handle budget and resource planning as per BP tools and processes Qualifications Required: - PhD or equivalent in chemistry, engineering, or related technical field - Minimum of 15 years experience in engine oils product development within the industry - Deep technical expertise in engine oil development and testing - Experience in building external technical relationships and industry insights - Strong project management experience with a track record of successful delivery - Excellent networking skills across functions and hierarchies - Collaborative approach to work with strong interpersonal and communication skills - Ability to lead meetings effectively in English,
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