claims auditor

Navi

<div>
 
 
 
 About the Team
 
 
 
 
 The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communications&mdash;across calls, chats, and other channels&mdash;to ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience.
 
 
 
 
 
 
 
 About the Role
 
 
 
 
 We are seeking an experienced doctor with medical knowledge for the process excellence vertical to join our dynamic team. As a vital member of our Process Excellence team, a quality auditor dedicated exclusively to auditing claims processed by medical officers to ensure accuracy, compliance, and continual improvement. A quality auditor conducts detailed reviews of claims, identifying areas for improvement.
 
 
 
 
 
 
 
 What We Expect From You
 
 
 
 <ul>
 <li>
 The role involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements
 </li>
 <li>
 Review health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations.
 </li>
 <li>
 Identify any inconsistencies, overbilling, or discrepancies between the services provided and the claims submitted
 </li>
 <li>
 Detect potential fraudulent claims by analyzing patterns and identifying suspicious activities or behaviors
 </li>
 <li>
 Suggest process improvements to enhance the efficiency and accuracy of the claims audit process.
 </li>
 <li>
 Stay updated with industry trends, regulations, and changes in healthcare policies that may impact claims auditing.
 </li>
 </ul>
 
 
 
 
 
 
 Must Haves
 
 
 
 <ul>
 <li>
 Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS)
 </li>
 <li>
 Experience in handling an audit
 </li>
 <li>
 Background in claims processing with clinical experience in a hospital setting
 </li>
 <li>
 Data analytics experience would be an added advantage
 </li>
 <li>
 Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory.
 </li>
 <li>
 Knowledge of health insurance policies and regulations, IRDAI circulars is a must
 </li>
 <li>
 Strong analytical and problem-solving skills.
 </li>
 <li>
 Excellent attention to detail and ability to spot discrepancies
 </li>
 <li>
 Ability to anticipate potential problems and take appropriate corrective action
 </li>
 <li>
 Effective communication skills for working with different stakeholders
 </li>
 <li>
 Time management skills to meet deadlines.
 </li>
 <li>
 Should have a broad understanding of Claims Practice
 </li>
 <li>
 Sharp business acumen to understand health insurance claim servicing needs
 </li>
 <li>
 Excellent communication skills, including writing reports and presentations
 </li>
 </ul>
 
 
 
 
 
 
 Inside Navi
 
 
 
 
 We are shaping the future of financial services for a billion Indians through products that are simple, accessible, and affordable. From Personal &amp; Home Loans to UPI, Insurance, Mutual Funds, and Gold &mdash; we&rsquo;re building tech-first solutions that work at scale, with a strong customer-first approach.
 
 
 
 
 
 Founded by Sachin Bansal &amp; Ankit Agarwal in 2018, we are one of India&rsquo;s fastest-growing financial services organisations. But we&rsquo;re just getting started!
 
 
 
 
 
 
 
 Our Culture
 
 
 
 
 The Navi DNA
 
 
 
 Ambition. Perseverance. Self-awareness. Ownership. Integrity.
 
 
 
 We&rsquo;re looking for people who dream big when it comes to innovation. At Navi, you&rsquo;ll be empowered with the right mechanisms to work in a dynamic team that builds and improves innovative solutions. If you&rsquo;re driven to deliver real value to customers, no matter the challenge, this is the place for you. We chase excellence by uplifting each other&mdash;and that starts with every one of us.
 
 
 
 
 
 
 
 Why You'll Thrive at Navi
 
 
 
 
 At Navi, it&rsquo;s about how you think, build, and grow. You&rsquo;ll thrive here if:
 
 <ul>
 <li>
 
 You&rsquo;re impact-driven :
 
 You take ownership, build boldly, and care about making a real difference.
 </li>
 <li>
 
 You strive for excellence
 
 : Good isn&rsquo;t good enough. You bring focus, precision, and a passion for quality.
 </li>
 <li>
 
 You embrace change
 
 : You adapt quickly, move fast, and always put the customer first.
 </li>
 </ul>
</div>

Claims Manager - Medical Claim Audit

<div>
 
 
 
 About the Team
 
 
 
 
 The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communications&mdash;across calls, chats, and other channels&mdash;to ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience.
 
 
 
 
 
 
 
 About the Role
 
 
 
 
 We are seeking an experienced doctor with medical knowledge, analytical skills for process excellence to join our dynamic team..The ideal candidate will be responsible for strategic claim auditing, insight-driven reporting, stakeholder engagement, and improvement areas. The auditor should be able to identify patterns and process gaps. will collaborate with cross-functional teams like claims, network providers, and investigations. product, analytics, automation &amp; compliance to ensure successful delivery of initiatives.
 
 
 
 
 
 
 
 What We Expect From You
 
 
 
 <ul>
 <li>
 Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations.
 </li>
 <li>
 Identify any inconsistencies, overbilling, or discrepancies between services provided and the claims submitted
 </li>
 <li>
 Detect potential fraudulent claims by analyzing patterns and identifying suspicious activities or behaviors
 </li>
 <li>
 Providing detailed reports on audit findings, Decision accuracy, including identifying overpayments, underpayments, or fraudulent activities
 </li>
 <li>
 Recommend actions based on findings, such as denying, reducing, or adjusting claims
 </li>
 <li>
 Communicate audit results and findings to management and external stakeholders
 </li>
 <li>
 Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations.
 </li>
 <li>
 Identify any inconsistencies, overbilling, or discrepancies between services provided and the claims submitted
 </li>
 <li>
 Detect potential fraudulent claims by analyzing patterns and identifying suspicious activities or behaviors
 </li>
 <li>
 Providing detailed reports on audit findings, Decision accuracy, including identifying overpayments, underpayments, or fraudulent activities
 </li>
 <li>
 Recommend actions based on findings, such as denying, reducing, or adjusting claims
 </li>
 <li>
 Communicate audit results and findings to management and external stakeholders
 </li>
 </ul>
 
 
 
 
 
 
 Must Haves
 
 
 
 <ul>
 <li>
 Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS)
 </li>
 <li>
 Experience in handling audit
 </li>
 <li>
 Background in claims processing with clinical experience in a hospital setting
 </li>
 <li>
 Data analytics experience would be an added advantage
 </li>
 <li>
 Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory.
 </li>
 <li>
 Knowledge of health insurance policies and regulations, IRDAI circulars is must
 </li>
 <li>
 Strong analytical and problem-solving skills.
 </li>
 <li>
 Excellent attention to detail and ability to spot discrepancies
 </li>
 <li>
 Ability to anticipate potential problems and take appropriate corrective action
 </li>
 <li>
 Effective communication skills for working with different stakeholders
 </li>
 <li>
 Time management skills to meet deadlines.
 </li>
 <li>
 Should have a broad understanding of Claims Practice
 </li>
 <li>
 Sharp business acumen to understand health insurance claim servicing needs
 </li>
 <li>
 Excellent communication skills, including writing reports and presentations
 </li>
 </ul>
 
 
 
 
 
 
 Inside Navi
 
 
 
 
 We are shaping the future of financial services for a billion Indians through products that are simple, accessible, and affordable. From Personal &amp; Home Loans to UPI, Insurance, Mutual Funds, and Gold &mdash; we&rsquo;re building tech-first solutions that work at scale, with a strong customer-first approach.
 
 
 
 
 
 Founded by Sachin Bansal &amp; Ankit Agarwal in 2018, we are one of India&rsquo;s
 
 
 fastest-growing financial services organisations. But we&rsquo;re just getting started!
 
 
 
 
 
 
 
 Our Culture
 
 
 
 
 
 
 The Navi DNA
 
 
 
 
 
 Ambition. Perseverance. Self-awareness. Ownership. Integrity.
 
 
 
 We&rsquo;re looking for people who dream big when it comes to innovation. At Navi, you&rsquo;ll be empowered with the right mechanisms to work in a dynamic team that builds and improves innovative solutions. If you&rsquo;re driven to deliver real value to customers, no matter the challenge, this is the place for you. We chase excellence by uplifting each other&mdash;and that starts with every one of us.
 
 
 
 
 
 
 
 Why You'll Thrive at Navi
 
 
 
 
 At Navi, it&rsquo;s about how you think, build, and grow. You&rsquo;ll thrive here if:
 
 <ul>
 <li>
 
 You&rsquo;re impact-driven
 
 : You take ownership, build boldly, and care about making a real difference.
 </li>
 <li>
 
 You strive for excellence
 
 : Good isn&rsquo;t good enough. You bring focus, precision, and a passion for quality.
 </li>
 <li>
 
 You embrace change
 
 : You adapt quickly, move fast, and always put the customer first.
 </li>
 </ul>
</div>

Senior Claims Manager - Medical Claim Audit

Rixos

<div>Company Description 
We are far more than the worldwide leader. We welcome you as you are and you can find a job and brand that matches your personality. We support you to grow and learn every day, making sure that work brings purpose to your life, so that during your journey with us, you can continue to explore Accor / Ennismore's limitless possibilities. By joining us every chapter of your story is yours to write, and together we can imagine tomorrow&rsquo;s hospitality.
Rixos Bab Al Bahr is a luxury hotel chain providing a traditional Turkish hospitality in an excellent manner. changing the concept of a real luxury by giving a new meaning of the all-inclusive holiday concept through providing a unique experience.
SALARIES AND BENEFITS<ul><li>
Competitive Salary</li><li>
Duty Meals provided; breakfast/lunch/dinner/midnight meal + coffee breaks</li><li>
Vacation tickets /benefits provided by the hotel</li><li>
Medical Insurance Provided</li></ul> 

Job Description 
We are seeking a detail-oriented and analytical Income Auditor to join our team. As an Income Auditor, you will play a crucial role in ensuring the accuracy and integrity of our financial records by conducting thorough audits of revenue-related documents and processes.<ul><li>
Verify and reconcile revenue documents against revenue sheets and general ledger balances</li><li>
Identify and investigate discrepancies in financial records, proposing corrective actions when necessary</li><li>
Analyze and optimize the use of financial resources, educating team members on best practices</li><li>
Secure and manage revenue-related documents, including guest checks, folios, receipts, and vouchers</li><li>
Audit and account for all control documents, preparing exception reports for errors</li><li>
Ensure that rebates, allowances, and adjustments against revenue are properly authorized and legitimate</li><li>
Collaborate with other departments to improve financial processes and internal controls</li><li>
Prepare accurate and timely financial reports for management review</li><li>
Stay updated on relevant accounting standards and regulatory requirements</li></ul> 

Qualifications 
<ul><li>
Bachelor's degree in accounting, Finance, or a related field</li><li>
Minimum of 3 years of experience in income auditing or a similar role, preferably in the hospitality industry</li><li>
Strong analytical and problem-solving skills with a keen eye for detail</li><li>
Advanced proficiency in Microsoft Excel and other financial software applications</li><li>
In-depth knowledge of accounting principles, auditing procedures, and financial reporting standards</li><li>
Excellent organizational skills with the ability to manage multiple priorities efficiently</li><li>
Strong attention to detail and commitment to accuracy in all tasks</li><li>
Ability to work independently and collaboratively in a fast-paced environment</li><li>
Familiarity with local tax regulations and financial practices in the UAE.</li></ul></div>

Income Auditor

Accor

<div><div>Company Description</div> 
At Accor, we believe that hospitality is a work of heart. We understand the ways in which individual passion for our work and a shared sense of accomplishment create a more rewarding experience for our guests. We foster this culture through a diverse and inclusive workplace that values the contribution of each and every member of our team. We are committed to taking positive action in terms of business ethics and integrity, responsible tourism, sustainable development, community outreach, and diversity and inclusion. With an expansive portfolio of iconic hotels and brands, Accor offers boundless opportunities for career advancement and professional development across the globe.
Join a team where you can be all you are, grow and create your path, work with purpose, and enjoy and feel valued.
This is a senior role with scope for real impact and growth possibilities for an ambitious applicant. Make it your next move.<div> 
Job Description</div> 
We are seeking a detail-oriented and analytical Income Auditor to join our finance team at Swissotel Corniche Park Towers Doha, Qatar. As an Income Auditor, you will play a crucial role in ensuring the accuracy and integrity of our financial records by conducting thorough audits and maintaining precise financial documentation.<ul><li>
Audit and balance all front office postings, settlements, and hotel reports to ensure accuracy and compliance with financial standards</li><li>
Manage month-end deadlines and schedules, preparing income journal entries in a timely manner</li><li>
Reconcile credit card commissions, food and beverage point of sale systems, and monitor front office rebates</li><li>
Review and authorize food and beverage voids, paid outs, and miscellaneous charges</li><li>
Prepare and distribute daily operational packages to relevant departments, providing clear and concise financial information</li><li>
Assist with month-end closing procedures and perform account analysis to identify and report discrepancies</li><li>
Support the General Cashier with surprise float counts and step in for the Audit Supervisor when necessary</li><li>
Collaborate with various departments to ensure smooth financial operations and resolve any discrepancies</li><li>
Implement and maintain internal control procedures to safeguard company assets and ensure compliance with financial regulations</li><li>
Stay updated on industry trends and best practices in income auditing and financial management</li></ul><div> 
Qualifications</div> 
<ul><li>
Bachelor's degree in Accounting, Finance, or a related field</li><li>
Proven experience in income auditing, preferably in the hospitality industry</li><li>
Strong knowledge of generally accepted accounting principles (GAAP) and financial reporting standards</li><li>
Proficiency in accounting software and Microsoft Office Suite, particularly Excel</li><li>
Excellent analytical and problem-solving skills with a keen eye for detail</li><li>
Strong mathematical abilities and accuracy in numerical data handling</li><li>
Ability to manage multiple tasks and meet tight deadlines in a fast-paced environment</li><li>
Effective communication skills, both verbal and written, to interact with various stakeholders</li><li>
Experience with hotel property management systems and point of sale systems is preferred</li><li>
Knowledge of local tax regulations and financial compliance requirements in Qatar is a plus</li><li>
Demonstrated ability to work independently and as part of a team</li><li>
Strong ethical standards and commitment to maintaining confidentiality of financial information</li></ul><div> 
Additional Information</div> 
Your team and working environment: 
In 1-2 sentences, introduce the team, property or office environment in a way that reflects the culture 
Note: Customization may be included for any specific local or legislative requirements, such as work permits</div>

<div>Company Description 
The Iconic Rixos Gulf Hotel Doha introduces a unique lifestyle and luxurious Services and products, Rixos warm hospitality, the vibrant Entertainment programs, and the trendy and distinguished ALL INCLUSIVE Food and Beverage concepts with 378 beautifully appointed guest Rooms, dream bedding and luxurious atmosphere. Join our motivated and vibrant Team as Income Auditor and build your career with us. 
Job Description 
<ul><li>
Reviews the work of the F &amp; B department and Night Audit ensuring accuracy of the information as reported.</li><li>
Properly allocates revenues and posts to the appropriate ledger accounts.</li><li>
Reviews and verifies the accuracy of revenues reported to Accounts Receivable by balancing the accounts to appropriate ledgers. This is done on a daily and monthly basis.</li><li>
Reviews and properly codes for posting and reporting all SP charges.</li><li>
Provides assistance in the closing of books at month end.</li><li>
Prepare any daily weekly or monthly reports as may be requested by management from time to time.</li><li>
Perform any other duties assigned by the Senior Accountant, Chief Accountant and or Director of Finance.</li><li>
Must possess basic computational ability.</li><li>
Thorough knowledge of computer processing system and ability to manually perform these operations if necessary.</li><li>
Ability to prepare and analyse data figures and transcriptions prepared on and generated by computer.</li><li>
Knowledge of computer accounting programs math skills as well as budgetary analysis capabilities required.</li><li>
Control on rebates and refunds on credit card.</li><li>
Ensure that commission is processed timely for all T/A.</li></ul> 

Qualifications 
<ul><li>
Bachelor in Finance or degree in vocational hospitality.</li><li>
3 &ndash; 5 years' experience in 4&ndash;5-star hotel.</li></ul></div>

Millennium Hotels and Resorts MEA

<div>As an Income Auditor, you will play a critical role in ensuring the accuracy and integrity of financial data related to hotel revenue. Your responsibilities will include auditing revenue records, reconciling accounts, and providing valuable insights to maintain financial transparency and compliance.
Key Job Responsibilities:<ul>
<li>
Conduct daily audits of revenue transactions, including room revenue, food and beverage sales, and other income sources.</li>
<li>Verify the accuracy and completeness of revenue records and supporting documents.</li>
<li>Reconcile revenue accounts and resolve discrepancies promptly.</li>
<li>Prepare detailed reports on revenue audits, highlighting variances and irregularities.</li>
<li>Communicate audit findings to relevant departments and management.</li>
<li>Ensure compliance with financial regulations, accounting standards, and company policies related to revenue recording.</li>
<li>Assist in internal and external audits related to income and revenue.</li>
<li>Provide insights and analysis of revenue data to support decision-making.</li>
<li>Identify trends and opportunities for improvement in revenue management.</li>
<li>Collaborate with the head of finance on financial analysis projects.</li>
<li>Maintain accurate and organized records of revenue-related documents and audit reports.</li>
<li>Ensure the safe storage and confidentiality of financial data.</li>
<li>Provide training to colleagues involved in revenue recording and reporting.</li>
<li>Foster open communication and cooperation among team members.</li>
<li>Work with financial software and systems to ensure accurate recording and reporting of revenue data.</li>
<li>Collaborate with IT and finance teams to optimize system functionality.</li>
<li>Operate in a safe and environmentally friendly manner, prioritizing guests' and colleagues' health and safety, as well as environmental conservation.</li>
<li>Adhere to hotel environmental, health, and safety procedures and policies.</li></ul></div>

NMC Health plc

<div>3.1 Review and Audit Medical Claims to ensure their accuracy.
3.2 Resubmission of rejected claims
3.4 Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers
3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.</div>
 <div><ul><li>Review and Audit Medical Claims to ensure their accuracy.
 </li><li>Resubmission of rejected claims
 </li><li>Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers
 </li><li>Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
 </li><li>Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
 </li><li>Submit the claims with proper codes and format to insurance companies within the stipulated time.</li></ul></div>
 <div><ul><li>Medical/Nursing graduate from a recognized university.
</li><li>Experience in Insurance Claims Resubmission
</li><li>Experience in Medical Coding is preferable.
</li><li>Excellent command of oral and written English.</li></ul></div>

Medical Auditor

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