www.icaretpa.com I-Care Health Management & TPA Services Pvt Ltd Hyderabad : Insurance Claims Auditor

[Admin]

I-Care Health Management & TPA Services Private Limited
www.icaretpa.com

Keywords: Claims Auditor, Hospital Bills Auditor , TPA experience

Designation: Claims Auditor
Experience: 2 - 6 Years
Location: Hyderabad / Secunderabad
Compensation:
"As per Industry Standards"
Education: UG - Any Graduate - Any Specialization
PG - Post Graduation Not Required
Industry Type: Insurance
Functional Area: Banking, Insurance
Posted Date: 08 Dec 2008

Job Description
-Will be responsible for checking all the claims (authorization, cashless claim, reimbursement claim and OPD claim) to ensure that they are in line with the insurance policy.
-Making sure that there is zero error in the claims paid to the insured or the service provider.
-Should warn of possible fraud claims to the CMO to initiate investigations.
-Should check the quality of queries raised on the customer, insurer or service provider.
-Will be responsible for auditing the group or individual policy terms and conditions once underwritten in the software.
-Will be responsible for training the users and claims team in avoiding errors.

Desired Candidate Profile
Strong Knowledge and experience in health Insurance policies being issued by the various insurance companies.
Strong Knowledge of TPA work flow process and insurance companies working.
Eye for errors.
Good observation, Networking and Team Handling ability.
Basic Computer Knowledge, Ms office.

Company Profile
I-Care is a start-up company in the TPA industry with its Head Office located in Hyderabad. It has been started by a set of very ambitious and highly experienced professionals in the TPA field. We are currently on a massive expansion spree across the country and have a huge requirement for able and dynamic people.

Executive Name: Ms.Rekha

Address:
#56, Syndicate Bank Officer's Colony,
West Marredpally,
Secunderabad,A.P,INDIA 500026

Email Address: rekha.s@icaretpa.com

Telephone: 91-040-40130620

Reference ID:
CAd00123

[dr.pramod]

Respected Sir / Madam ,
I 'Dr,Pramod B. Jagdale' is currently working as Medical Advisor , in a Third Party Administration company .My current job profile inculdes -

TO CONTROLL THE FUNCTIONAL FLOW OF MEDICLAIMS TILL PAYMENT OR REPUDIATION OF CLAIMS ,

TO LEAD THE TEAM IN ALL ASPECTS REGARDING RESULTS OF PARTICULAR BUISNESS AREA & INSURANCE COMPNAIES ( Both Govt. & Private Insurance Co.)

. Medical processing as well as Audit of Reimbursement Claim documents up to the claim value of Rs.750000/-.

Claim Document Management which includes scheduling the weekly target and work allocation.

Resolving various issues related to claim settlement.

Controlling Additional Document Request (ADR) ratio to Insurance Company, patient(Non-cashless claims) and hospital (cashless claims) and keeping it to minimum.

Maintaining Turn Around Time (TAT), settling claims as per priority, corporate claims and resolution of grievance / issues by supervising weekly loading of work.

Improvising the current operational procedures by defining problems, analyzing feasibility and implementing simple procedures to achieve the goal.

Managing Branch co-ordination with respect to priority settlements.

Planning manpower requirements considering different factors..



Expecting a hopeful reply !
Thank you !

[goklaninand]

CLEARLY MENTION THE PACKAGE UR PROVIDING

jai kavitha good evening

i am searching for job in tpa and one of my friend was informed to me it has openings in icare tpa in bangalore i need information about how to apply and to whom i have to contact please give me some information.

I-Care Health Management & TPA Services is a company who enters in the business of Tpa Industry,My warm wishes to this company to grow in the TPa industry & provide better services to their bonified customers

Regards
Saket
raisaket95@yahoomail.com
New Delhi
09312851488

iam rajendra hajgude presently working with mdindia healthcare pune as a pune branch incharge since two years, looking for the new assignement.

If Any Requirement In Mumbai Pls Contact Me

Particular emphasis is placed on the present health care scenario in India and international field generally. A global comparison of selected Asian countries, regarding their national incomes and health expenditure in public and private sectors, generates insights

if any types of Jobs Requirement in mumbai Pls Contact Me On 9869135315 Of Send Me Email on prasad_gaikwad0709 AT rediffmail.com

Respected Sir/ Madam,

I "P Praveen Kumar" is currently working as processing Associate, in ICICI LOMBARD (I Health care) Cashless process.

I Dr Ahmed Firaz with working experience in TPA Health Insurance. my mail ID is firazah AT gmail.com

I am working in TPA since 4 years.Kindly contact me if you need my services.

Dr Mahedhwari

Your offers are really good.Can you say me the best packages you offer for medical claims.

I Dr Musharraf Husain having MBA degree in health care services working with fortis hospital noida and hading TPA dept. if there is any position i am open for that. my mail id is mush20sep AT gmail.com

HI-THIS IS UMESH KUMAR, I HAVE 2 yrs Exp.in TPA(UNIVERSAL MEDI-AID SERVICES Pvt. Ltd
PLs GIVE ME ANY RESPONSE On UMESH_UMSLTPA AT YAHOO.COM

iam managing director shashank multispeciality hospital in nizamabad,AP we are intrested to provide network hospital services to your tpa,our is 75 bed multispeciality hospital ,looking fprward reg, your resp, cantact dr,mothilal MDshashank hospital nizamabad AP,phone;09885445913,08462254444,250913,fax;08462254444


thankingyou

dr mothilal

sir i have lost my icare healthinsurance cards please contact me at:9908199090,9010234410

Dear Team I Care,

Please let me know if my identity and interview with you will be kept a secret from my existing TPA.

I Mr Ramgopal working as Claim investigator - Life in Bajaj Allianz Life Insurance Co Ltd and also dealing with Doctors empanelment across locations of Karnataka and Andhra Pradesh.
My best wishes to I-Care Health Management & TPA Services, Hyderabad .

HI, iam prasanna i have 3.6 years experience of customer relations.i am looking for a opening in hyderabad,please contact me for any openings

Email id: prasannacute@yahoo.com

[Guest]

Curriculum vitae
K. Praveen Kumar
E-Mail : Kancharlapraveenkumar AT gmail.com
_______________________________________________________________________
Career Objective :
To secure a challenging and responsible position in a corporative environment, in which initiative skills, ambitions and commitment to excellence are utilized to their full potential.
Field Exposure :
Worked for Acure Home Care Physical Therapy as Quality Analysist, Michigan,
USA, From 16-Dec-2008 till 20-Feb-2010
Worked for Nihar Orthopaedic & Multi speciality hospital, Ameerpet, Hyderabad, as consultant Physical Therapist, full time from 1-March-2005 till 25-July-2007
Area Of Strength :
- Treatment of patients with disabilities
- Rehabilitation Services
- Community based Rehabilitation
- Counseling services for those in need
- Identification, plan and execution of apt treatment in correspondence with patients requirement
- Methodological approach in rehabilitation of patients, demonstrated ability in promoting Health education and High public relation skills helped to deliver high quality CBR.
Job Profile :
- Treating patients with multiple disabilities regarding orthopaedic, neurological, cardio-respiratory, sports injury, geriatric and pediatric
- Rehabilitation of patients with chronic illness
- Record maintenance and statistical analysis and modification of treatment as per requirement
- Assessment and treatment of patients with doctors, referrals treatment of patients in the OP those admitted as inpatients
Scope Of Treatment :
Conditions treated includes Orthopeadic, Respiratory, Paediatric, Geriatric, Burns, Cardio thoracic surgery, General surgery conditions and Obesity management are also our prime area of experience.
Area Of Interest :
- Towards academic and clinical research.
Professional Training
Clinical experience during under graduation in the following departments
- Orthopaedic in and out patient department, Neurology, Neurosurgery, Cardio Thoracic Surgery, Physiotheraphy, ICU management at Govt General Hospital, Guntur.
- Neurology department Lalitha Superspeciality Hospital, Guntur.
- Physiotherapy Department, SIMS College, Guntur.
Project Work
Project work done on Physiotherapy management in Chronic Bronchitis under supervision of Dr. K. Ram Prasad, MPT-Australia.
Professional Qualifications :
- Masters of Business Administration in Health Care, from Herguan University, Sunnyvale, California, USA. 2009-2011.
- Bachelor of Physical Therapy from Southern Institute of Medical Sciences, NTR University of Health Sciences, Guntur. 1998-2004.
- Intermediate (Botany, Zoology, Physics, Chemistry) from GJC, Domakonda, Nizamabad . 1993-1995.
- Passed Tenth in Board of Secondary Education from ZPHS, Mallareddy, Nizamabad, 1992-1993.

[Guest]

CURRICULUM – VITAE
PRINCEY NIGAM
princey812 AT rediffmail.com
Career Objective :
To rise in life with zeal and passion. I am a firm believer that drops can fill the ocean with perseverance & energy. I want to turn opportunities into results.
WORK EXPERIENCE :

Organization Name :
RELIANCE WEBWORLD (July . 07 – May. 2008)
Worked as a FRONT SERVICE DESK.
Responsibilities handled during this tenure include :

- Responsible for Sales, Sales Promotion & Customer Care.
- System Handling & Billing.
- Resolving every customer complaint effectively within specified time frames
- Responsible for Customer Satisfaction.
- Inventory management.
- Co-ordinating with reliance team force.
MDIndia Healthcare Services (TPA) Pvt Ltd. (June 2008- Mar 2010)
Worked as a Customer Care Executive (Operations).
Responsibilities handled during this tenure include :
- System Handling .
- Resolving every insured complaint effectively within specified time frames.

- Responsible for Insured Satisfaction.
Lucknow Hospital (Apr. 2010-Till Date)
Worked as a T.P.A Co-ordinator.
Responsibilities handled during this tenure include :
- Empanelled of Hospital with T.P.A
- Total billing work and Management.
- All leading Insurance Companies and T.P.A.
Qualifications :
- B.COM from LUCKNOW UNIVERSITY in 2006.
- INTERMEDIATE from. U.P.BOARD in 2003.
- HIGHSCHOOL from .U.P.BOARD in 2001

Computer Proficiency

EXCEL, POWERPOINT, MS WORD, TALLY, DTP (desktop publication) & INTERNET.

[Guest]

RESUME
OBJECTIVE
Seeking position as cardiac ICU nurse in an ambulatory care hospital where my experience of 2 years in intensive care unit as cardiac nurse and working knowledge of patient care,cardio vascular system,and cardiac transplant,cardiomyopathy,and teamwork ability can be utilized effectively.
:MR.MOHAMMED EHTESHAM

Email ID :ethesham.md AT gmail.com
Hobbies :PLAYING CRICKET,READING STORIES

EUDCATION QUALIFICATION :
Examination
School / College
Board/ University
Year of Passing
Diploma in General Nursing and Midwifery
JAYA SCHOOL OF NURSING(MEDWIN HOSPITAL)
INDIAN NURSING COUNCIL.
01/09/09
INTERMEDIATE
DATAR VOCATIONAL JUNIOUR COLLEGE.
BOARD OF INTERMEDIATE EDUCATION.
01/03/06
S.S.C
MAGNIFIC HIGH SCHOOL.
BOARD OF SECOUNDARY EDUCATION.
2004
OTHER ACHIEVEMENTS :
Passed Inservice Education In Cario-Thoracic Nursing From [MEDWIN HOSPITAL]
ADVANCE CARDIAC LIFE SUPPORT FROM[MEDWIN HOSPITAL]
BASIC LIFE SUPPORT FROM[MEDWIN HOSPITAL]
X-RAY TECHNICIAN
MEDICAL LABORATORY TECHNICIAN
FIRST AID CERTIFICATE FROM GOVT.OF A.P
EMPLOYMENT DETAILS :
Working as a staff nurse inintensive cardio-thoracic unit (ICCU) cum emergency and ambulance service since 15.05.2009(Still Working)
DUTIES RESPONSIBILITIES :
Comprehensive Nursing care for all assigned patients
Receiving And Managing Patients With Medical Conditions Like Myocardial Infarction, Cadiogenic Shock-CCF, Cardiac And Respiratory Arrest Etc.
Giving Care Of Patients With Multiple Support
Caring Of Patients With Dialysis
Caring Of Patients With Post PPI, PTCA Angiography, Embolectomy, EPS, RFA (Electrophsiological Study And Radio Frequency Ablation).
Care Of Patients With Tracheostomy, Ventillator PROCEDURES, I DONE AND ASSISTED :
Insertion Of IV Cannula
Collection Of Blood Specimen
Emergency Resuscitation Procedure
Endotracheal / Tracheostomy Oral And Nasal Suctioning.
Tracheostomy Care.
Insertion Of Nasogastric Tube.
Total Parenteral Nutrition
Wound Irrigation And Dressing
Blood Transfusion
Catherterisation
Administration Of Medications.
Insertion Of Urinary Carheter
Defibrillation CPR
Pleural Taping
Peritoneal Dialysis
Suture Rermoval
Ultra Sonogram Assisted In Neckline, TPI, Trachostomy, Pericardiocentesis, IABP Insertion
EQUIPMENT HANDLED :
Cardiac Monitor
Defibrillator
Pluse Oxygenator
Syringe Pump
Glucometer
Nebulizer
Alpha Bed
Typanic Thermometer
Sphygmomanometer
IABP Machine
Temporary Pacemaker
Ventillators & BIPAP
HOSPITAL PROFILE :
(MEDWIN HOSPITAL) is a 300 bedded multi speciality hospital, providing compete and comprehensive heart care to all ages. M.M.M have 5 operation theatres 24 bedded adult ICU, 16 bedded paediatric ICU, 12 bedded CCU 24 hours cardiac emergency, male and general wards, pecdiatric wards, deluxe and superdeluxe rooms. (MEDWIN HOSPITAL) Performs 2000 cardiac surgeries per year including CABGS, OPCAB, Valve surgeries, complex paediatric surgeries such as canal repair, I.C.R., and T.A.P.V.C etc. (MEDWIN HOSPITAL) also perform various therapeutic and diagnostic intervantion in cardiology such as angiogram, angioloasty, E.P.S. + R.F.A., Muga and thallium test cardia catheterization etc. Apart from this we have another DEPARTMENT LIKE RENAL TRANSPLANT CENTRE which is specialized transplants such as kidney, liver & heart etc & department of reproductive medicine.
INSERVICE EDUCATION COURSE ATTENDED.
COURSE INSTITUTION YEAR
Bsic life support course MEDWIN 2009
Preventive and rehabilitative cardiology MEDWIN 2008
Introduction to computers MEDWIN 2008
Medical & Surgical Management of Renal Disease MEDWIN 2010
Clinical psychology MEDWIN 2008
Clinical cardiology MEDWIN 2011
Principles of anesthesia for nurses MEDWIN 2011
E.C.G. Interpretation MEDWIN 2011

[Guest]

ANJUM ASHRAF

ID –anjumashraf123 AT .gmail.com
PROFESSIONAL QUALIFICATION
B.Sc Engineering from Maulana Azad College of Engg & Tech-Patna
ADDITIONAL QUALIFICATION
Done crash course In (Window-98, MS DOS, Power Point, Tally-5.4)
Under gone insurance training of 50 hours in conducted BY IRDA in RNIS college of Insurance
CAREER OBJECTIVE
To hold the legitimate position in the organization from where I can implement all my Professional skill and other sophisticated knowledge in most effective manner for the betterment and upliftment of the organization
_______________________________________________________________
CAREER TILL NOW
# ASM IN USHA INTERNATIONAL LTD (USHA LEXUS HOME APPLIANCE)
# ASM IN ZYTRAS LIFE SCIENCES-PHARMACUTICAL COMPANY-BIHAR
# JOINED MEDICARE AS DISTRICT CODINATOR FOR VAISHALI-BIHAR-RSBY PROJECT
# PROMATED AS MEDICARE TPA AS OPERATIONAL-HEAD FOR RSBY PROJECT
# JOINED M D INDIA TPA AS STATE HEADS FOR BIHAR-RSBY PROJECT
# WORKING FOR RAKSHA TPA PVT LTD AS ASST B.M –CORPORATE POLICY
LIKE R.B.I, VODAFONE, AIRCEL, AIRTEL, SBI LIFE, WHIRLPOOL & MANY MORE
ROLES AND RESPONSIBILITY
- Handling enrollment & distribution of health card under RSBY project
- Empanelment of hospital and nursing home for IPD in Bihar –Jharkhand
- Smooth and fast functioning of cashless facility
- Verification of bills and reimbursement paper
- Organizing health awareness camp under RSBY policy all over Bihar
- Handled both the sector Traditional policy and BPL policy
- Coordinating with company for corporate policy
-
STRENGTH
- Excellent interpersonal & Communication Skill
- Excellent team orientation and ability to develop effective relationship
- Having self-confidence to communicate effectively with people of different class
- Work Effectively With Diverse Groups Of People
- Good Observation for better result

[Guest]

Hi!
i am mehnaz have 2.5 years experience clinical side wants to move non-clinical side and looking for opening as T.P.A in hyderabad.though not experienced but if given a chance will prove to be the best.
recruiters can contact me on :-mehnaz.zahid65 AT gmail.com

[Guest]

doctor by profession wants to have a career as a tpa or claims doctor could anyone gimme a chance can contact me at mehnaz.zahid65 AT gmail.com
resume :
Dr.Mehnaz Zahid Quraishi
Email ID :mehnaz.zahid65 AT gmail.com

Objective :
Looking forward to work in an organization where I get an opportunity to learn and use the same for the growth of both the organization and me.
Work experience :
Powers : (November 2007 – June 2008)
- Worked as a spoken English trainer.
- Handled advanced batch for spoken English, corrected students grammatically.
- Conducted JAM sessions, debates, group discussions.
Globuzz : (June 2008 – June 2009)
- Worked as a language trainer as well as voice and accent trainer.
- Guided the enrolled student both grammatically and accent wise.
- Conducted JAM sessions, debates, group discussions, mock interviews and mock calls.
- Handled Interview handling classes.
Medical Practitioning : (September 2006-november2011)
Working as a medical practitioner on part time basis(Swapna health care as duty doctor).
Qualification :
- Pursuing MBA (HEALTH CARE SERVICES) from Sikkim Manipal University.
- Completed B.U.MS from Govt.Nizamia medical college-60%
- Completed intermediate from Madina junior College -80%
- Completed S.S.C from Madina Public School-74%
Strengths :
- Punctual
- Adaptable
- Responsible
- Good leadership skills
- Quick Learner
Interests :
- Reading books
- Listening to music
Hobbies :
- Cooking
- Learning new things
- Making friends

[Guest]

Our card is renewed are not?