Job summary
We are currently seeking TPA executives willing to work in the Insurance Claim/Mediclaim
department in a hospital.
Requirements
● Minimum 3 years of experience in a hospital as a TPA.
● Good communication skills
● Good knowledge of working on excel
● Willing to work in a hospital
Benefits
● Employee friendly work culture
● Rewards & Recognitions
Responsibilities
● To give the estimate to the patients according to the treatment advised and as per the
hospital tariff.
● To connect with Insurance company and get the relevant information required for
claims
● To treat all communication about patients, staff, and other organizational business
confidentially.
● To maintain appropriate departmental documentation.
● Coordinating all kinds of internal billing queries
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Role Title: Developer - Guidewire Integration-Config
Role Purpose
We are looking for a Developer for our Claims Guidewire team, who is a technology enthusiast, and eager to be part of a culture of modern software engineering practices, continuous improvement, and innovation.
As a Developer, you will be part of a dynamic engineering team and work on development, maintenance, and transformation of our strategic Claims Guidewire platform. You will learn about software applications, technology stack, ways of working and standards.
Key Accountabilities
· Deliver software development tasks for Claims Guidewire applications, in the areas of Integration and Configuration, with expected quality measures and timeframe, e.g., coding, writing unit test cases (G-Unit) and unit testing, debugging and defect fixing, providing test support, providing release support.
· Communicate with technical leads and IT groups for understanding the project’s technical implications, dependencies, and potential conflicts.
· Research issues reported in Production, perform root cause analysis and document them, respond to and resolve technical issues in a timely manner.
· Perform versioning of the release updates and resolve the code conflicts while merging and promoting the code to higher environments.
· Develop their technical and functional knowledge on Claims Digital Guidewire platform.
· Understand and follow Guidewire’s cloud standards for application development.
· Active participation in team meetings like daily stand-ups, risk forums, planning sessions and retrospectives.
Skills & Experience
· 3+ years of development experience on Guidewire cloud platform and applications, Guidewire certification preferred.
· Hands on development expertise on Guidewire ClaimCentre with configuration and integration
· Experience in Guidewire platform (Gosu scripting / Edge APIs / UI / Data Model)
· Should have knowledge on Admin data loading, Assignment and Segmentation Rules, Pre-update and Validation rules, Authority limits, Financials (checks, reserves, recoveries …)
· Good experience on LOB configuration and related type-lists
· Good experience on integration components including plug-ins, messaging (and supporting business rules), batches, REST APIs and programs that call the Guidewire application APIs.
· Experience on any database Oracle / SQL Server and well versed in SQL.
· Experience of working in a CI/CD setup and related tools/technologies
· Insurance domain knowledge with Property & Casualty background preferred.
Location- Gurugram
CTC- Upto 25lpa
ROLE MISSION (WHY THE POSITION EXISTS)
Responsible for managing the MD’s calendar, prepares any notes for the meetings, fixes appointments with visitors, internal staff, etc.
Prioritizes and follows up on concerns addressed to the MD, including those marked sensitive or confidential nature. Follows course of action as recommended by MD.
Drafting acknowledgement letters, personal correspondence, and other tasks that facilitate the MDs ability to perform his/her duties
Making transport and travel arrangements and preparing expense reports for the MD
Coordinates internally with internal departments and acts as a point of contact between internal and external employees, vendors, external clients and guests
Arranging minutes of meetings, conferences, Board meetings
Filing all important documents, correspondence for the MD’s office
Responsible for regular monthly reports as required by the Management
Coordinates with external organizations, as required
AREAS OF RESPONSIBILITY
Administrative Responsibilities:
- Responsible for calendar management, scheduling appointments and meetings
- Making transport and travel arrangements for the MD
- Be the point of contact to answers queries and providing
information related to the MD’s office
- Develop presentations as required by the MD
- Handles all correspondence for the MD’s office and prepare
responses and filing all important documents
- Manage information flow in a timely and accurate manner
- Delegating tasks assigned by MD to staff and follow up of status of all tasks assigned
- Collating MIS from all departments on a timely basis
- Handle confidential information in a sensitive manner
JOB SPECIFICATIONS
Education:
Bachelor of Commerce / Arts
MBA (Optional)
Job Related Experience:
6-8 years of work experience in administration with minimum 3 experience as a Executive Assistant to a Management role
Excellent computer proficiency required
Business Understanding:
Hospital Management
Others:
Excellent English Communication (Written and Verbal)
Excellent Presentation Skills
Department Corporate Agency and Broking Band 5A/5B/4
JOB SUMMARY:
Job PurposeTo Drive business through channel partner's sales team and distribution network.
Key Responsibilities:
1. To Build strong relationship across the partner network
2. To Grow the business by driving sales of MLI products through partner sales team
3. To Organize catch-up meetings with partners and their clients to introduce MLI products in their portfolios
4. To Activate maximum number of mapped sub-brokers/RMs/Lead Generators on a monthly basis
5. To Ensure smooth issuance of all cases from start to finish and maintain persistency of all issued policies
6. To Prepare and send daily report on meetings and sales numbers to all stakeholders
7. To Track the status of logged in policies in the central MIS
8. To Update on the tasks assigned for driving focused business through the task MIS
9. To Maintain and update the persistency data of the assigned cases
10. To Train partner RMs on MLI products and processes
KEY RELATIONSHIPS:
Internal:
Business Heads
MLI HR & Sales Training Team
MLI Operations Team
External:
Business Partners
Top Insurance Brokers
Top Clients
Measures of Success:
Actual sales generated vs plan
Accuracy and timeliness of sales reports
Actual activity vs targeted activity
Accuracy of competitor information;
up to date data; Identification of potential
contacts and conversion to channel
partner/customer.
DESIRED QUALIFICATIONS and EXPERIENCE:
Qualifications: Graduate / Post Graduate
Experience: 2 - 6 years of relevant in Insurance Sales in Broking / Banca Sales
Strategy & Operations Manager – 2022
JOB DESCRIPTION
As a Strategy & Operations Manager you are expected to Work closely with CEO and help streamline Operations for the best way forward through Guidelines, Standards Automation etc (understanding the current state and future state why is critical), for & through
Roles & Responsibilities:
A strategic & org level role to define/streamline/standardize overall Org Operations in alignment with the current & future goals of the company, through,
- Definition of Guidelines, Standard Operating Procedures etc. for all the operations/services in the company
- Identification of the areas of automation of manual/repetitive tasks as a part of project management/delivery and working with the team in identifying and automating through the right tools & techniques (for ex – Team Management Matrix, Timesheets, Customer Status Dashboards etc.)
- People & Management – for work, right utilization & upskilling
- Continuous Reviews, Audits & Feedback ensure adherence
- Use of the right tools & techniques for ease, reuse, scalability & management – across operations
- Definition & Delivery of Org specific reports – team management, project dashboards, customer management etc.
- Bringing in mature practices to the way we do business for the betterment.
- Helping avoid waste and add value – in terms of work executed, value delivered to the customers
To re-iterate, all the above to be in complete alignment with the Org – its goals, values, principles & culture. So, while the expectation is for you to define procedures & protocols – it cannot be a one size fits all approach. Our belief is Responsible Freedom. Structures/Governance are important, but not at the cost of flexibility. You should be able to strike the right balance.
Scope in terms of functions/departments:
- All the functions around the Business that we are in (Consulting, Technology), from an Operations perspective
- Training & Development
Team you will be working with:
- CEO & Org Maturity Team
- Org Performance & Customer Delivery Team
- Project Managers
Experience/Qualifications
- Insurance Technology space, with experience in the role, as per Job Profile (preferable: P&C/General Insurance and related Technologies) would be ideal for the role. Alternatively, experience in FinTech or BFSI is expected
- Minimum of 5 to 6 years – Our focus is not on the number of years of experience, but the passion/aggression to help support in building scalable business through the right Operations
- B Tech with MBA from Premier Institutes preferable
- Experience in tech project implementations – in the capacity of operations manager
ABOUT MANOMAY
Manomay is a Global IT Consulting & InsurTech Firm with an exclusive focus on the Insurance industry. With business technology alignment as the key emphasis, we work with multiple insurance companies both on Consulting (Strategic/Management/Implementation/ Measurement) and Technology (InsurTech Products and Custom Specific Solution Development). Our Customer Base is spread across USA and Caribbean Islands (Bermuda, Cayman Islands, Barbados, Bahamas, and Jamaica).
Whether it is Consulting or Software Development, our focus is to help Insurance Companies solve those “unsolved” problems, that are not yet comprehensively addressed in the current realm of Company and the Market. These span across legacy technology, rip & replace challenges, indecisiveness about enterprise IT, changing customer expectations & positioning, changing market dynamics, people & process challenges, integrations & associations etc.
Our Technology Stack is of latest order using a combination of the new gen technologies AI, ML, RPA, Digitization & Analytics etc. developed off Python and its frameworks (primarily) + other web frameworks like Angular and Node JS etc.
- Manage Denial procedures
- Process guidelines management
Key Performance Areas:
- Applying patient and insurance payments and corresponding contractual adjustment/write[1]offs/Offset for all bill types to accounts.
- Electronic scanning of Explanation of Benefits
- Preparing and processing credits and patient and insurance refunds and posting.
- Resolving misdirected payments and returning incorrect payments to sender.
- Copies any zero payments (denial) to the appropriate Patient Account representative for follow-up and post.
- Appealing both denied or underpayments.
- Correct and most debit/credit adjustments of misapplied payments to ensure accurate and timely reporting of accounts.
- Claim scrubbing and Claim submission
- Posting of Electronic Remittance Advice (ERA)
- Knowledge of Durable Medical Equipment is recommended
Skills required:
- Analytical skills
- Typing speed- at least 40 wpm
- MS office skills- MS excel proficiency is preferred
- Eye for details- error-free work
- Fair skills of English language knowledge and understanding
- Domain knowledge on medical billing is preferred but not mandatory
Educational Qualification & Work Experience
- Graduation in any stream
- Additional certification in typing, a medical prescription will be preferred
Individual abilities:
- Willing to work in night shift
- Self- driven/ self-starter
- Problem-solving ability- proactive approach to finding solutions
- Good interpersonal ability
- Career-oriented
Role: Appian/Unqork Senior Solution Architect/Practice Lead
Experience: 5+ Years
Location: Trichy / Bangalore /Chennai (Post Covid)
Shift: US EST or CST
Responsibilities
- Provide pre-sales technical/functional support to prospective clients and customers with minimal supervision
- Work with sales to create and submit proposals, promote sales effort by helping customers leverage low code/no code tools for software development life cycle
- Build a solution delivery team
- Provide day-to-day guidance and technical leadership to a team of Appian/Unqork (or other low code/no code platform) Administrators, Developers, and Data Architects.
- Act as the technical lead, leading interactions with customer business and technical teams
- Work closely and collaboratively with the project team to deliver on project scope
- Works collaboratively with the Client and Team to articulate the vision and outcomes of the project and each release, and translating that vision into an actionable plan; Effectively manage customer expectations
- Develop guidance on Release Management process, working with Team and Client
- Serve as the day-to-day Technical POC for VDart team
- Plan and coordinate release logistics with other application teams and Stakeholders, identifying and accounting for dependencies
- Contribute with original, creative thinking related to solving customer issues, creating relevant features, and advancing Appain/Unqork low code/no code automation tool strategy
- Lead detailed discovery and scoping calls
- Work closely with sales to review requirements and develop value-focused proposals
- Describe the benefits and value of integrating Appian/Unqork low code/no code tools to integrate into a customers’ SDLC
Skills and Qualifications
- Bachelor (BS) of Science degree in Computer Science, Engineering, Mathematics, Business, Management or equivalent disciplines.
- Certification in Appian or Unqork
- 7+ years of IT experience, including full cycle software/web development and release management/implementation knowledge
- 4+ years' experience in a technical leadership position with prior experience supervising and leading teams
- 2+ years' experience of successful implementations of very large Appian or Unqork solutions
- Technical leadership in implementing enterprise-class application delivery
- Experience with Agile development methodologies
- Excellent writing, presentation, negotiation and communication skills
- Strong analytical and organizational skills
- Ability to manage and prioritize multiple tasks simultaneously
- Ability to explain technical content to non-technical, business stakeholders
- Prior experience developing proposals to respond to customer needs preferred