claims manager

MedNet Egypt L.L.C

<div>
 
 
 MedNet Egypt
 
 is one of the leading managed care service organisations that cater to healthcare needs. We are looking for a skilled
 
 Assistant Manager - Claims
 
 who is responsible for Planning and managing the data entry and claims processing operations of MedNet UAE&rsquo;s Top Insurer in order to ensure the delivery of high quality claims handling services to customers within the defined turnaround times (TAT) in accordance with established policies and corporate guidelines in order to support the achievement of revenue targets and overall business objectives.
 
 
 
 
 
 
 Your Job:
 
 
 <ul>
 <li>
 Manage claims processing operations for provider network claims, direct reimbursements, and re-submissions, ensuring efficiency and compliance with turnaround times (TAT).
 </li>
 <li>
 Oversee claims settlement as per financial authority levels and ensure proper reserve management.
 </li>
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 Ensure quality assurance through spot-checking and audits, ensuring claims are processed accurately and efficiently.
 </li>
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 Monitor technological system performance and coordinate with the IT department for system enhancements to improve operational efficiency.
 </li>
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 Lead and develop teams by setting objectives, providing coaching, and offering continuous training to maintain high performance.
 </li>
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 Act as an external auditor for high-value claims, ensuring compliance with internal policies before submission to the Hub Manager.
 </li>
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 Act as an Account Manager for primary insurance companies and groups, ensuring service delivery aligns with SLAs.
 </li>
 <li>
 Drive continuous improvement in claims processes, cost reduction strategies, and workflow optimisation.
 </li>
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 Ensure compliance with local health insurance laws, MedNet, and Munich Re policies.
 </li>
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 Supervise claims processing reports to support decision-making and ensure compliance with corporate standards.
 </li>
 <li>
 Coordinate with internal teams and external stakeholders (insurance partners, brokers, providers) for efficient claims handling.
 </li>
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 Implement process improvements to enhance operational effectiveness and service quality.
 </li>
 </ul>
 
 
 
 
 
 Your Profile
 
 
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in Medicine, Pharmacy, or Dentistry.
 </li>
 <li>
 5+ years of experience in medical claims management, with at least 2 years in a supervisory role.
 </li>
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 Strong knowledge of medical coding and claims processing procedures.
 </li>
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 Excellent time management and database management skills.
 </li>
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 Strong leadership and team management capabilities.
 </li>
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 Problem-solving and analytical thinking to improve claims operations.
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 Customer-focused mindset with strong communication and stakeholder management skills.
 </li>
 <li>
 Ability to handle multiple priorities and work in a fast-paced environment.
 </li>
 <li>
 Proficiency in healthcare regulations and compliance standards
 </li>
 </ul>
 
 
</div>

Assistant Claims Manager

KALPATARU PROJECTS INTERNATIONAL LIMITED

<div>
 
 
 Job Opening for Contracts &amp; Claims at Kalpataru Projects International Ltd. Mumbai - Santacruz
 
 
 
 
 
 
 Overall min. 10+ years. Ideal candidate shall have experience of minimum five years in handling contract administration and claims management of Oil &amp; Gas construction projects
 
 
 
 
 
 
 Area of responsibilities:
 
 
 
 
 
 <ul>
 <li>
 Oversee main contract and subcontracts, ensuring contractual compliance and managing claims
 </li>
 <li>
 Prepare, manage and log all correspondences and issuing necessary notices
 </li>
 <li>
 Claims, variation and Extra Work claims preparation
 </li>
 <li>
 Prepare Extension of Time (EOT) requests and handle delay management
 </li>
 <li>
 Manage dispute resolution
 </li>
 <li>
 Monitor subcontractor&rsquo;s performance and to ensure compliance and meeting timelines
 </li>
 </ul>
 
 
 
 
 
 Competencies:
 
 Adaptability / Flexibility
 
 .
 
 
 
 
 Qualification:
 
 Graduate Mechanical Engineer
 
 
 
 
 
 
 Skills:
 
 
 
 Excellent communication and interpersonal skill
 
 
 
</div>

Contracts and Claims Manager

CMA CGM

Led by Rodolphe Saadé, the CMA CGM Group, a global leader in shipping and logistics, serves more than 420 ports around the world on five continents. With its subsidiary CEVA Logistics, a world leader in logistics, and its air freight division CMA CGM AIR CARGO, the CMA CGM Group is continually innovating to offer its customers a complete and increasingly efficient range of new shipping, land, air and logistics solutions.
 
Committed to the energy transition in shipping, and a pioneer in the use of alternative fuels, the CMA CGM Group has set a target to become Net Zero Carbon by 2050.
 Through the CMA CGM Foundation, the Group acts in humanitarian crises that require an emergency response by mobilizing the Group’s shipping and logistics expertise to bring humanitarian supplies around the world.
 
Present in 160 countries through its network of more than 400 offices and 750 warehouses, the Group employs more than 155,000 people worldwide, including 4,000 in Marseilles where its head office is located.
 
JOB DESCRIPTION
 
Job Title : Assistant Manager
 
Department : Legal and Claims
 
Sub Department : -
 
Reporting : General Manager
 
Role Summary: 
Monitor and handle all legal issues regarding claims matters. Handle all sorts of recovery actions such as outstanding freight, detention, and demurrage, abandoned and longstanding containers, more generally all costs and expenses incurred by CMA CGM and recoverable from third parties.
 
Core Responsibilities: 
In case of new claims acknowledge receipt of claims within 24 hours of receipt of claim/notification.
 
Gather all relevant documents and report to HO all claims within 24 hours. Advise on the merits of the claim and future steps to be taken.
 
Monitor and assist HO claims as well other colleagues in handling of claims and court cases till its closure.
 
Monitor and handle all P&I related matters such as cargo claims, GA & stowage etc.
 
Monitor and handle all third-party damages to CMA CGM containers and cargo, including specifically stevedore damages and to ensure prompt reserves are taken against such third parties.
 
Handle all sorts of recovery actions such as outstanding freight, detention, and demurrage, abandoned and longstanding containers, more generally all costs and expenses incurred by CMACGM and recoverable from third parties.
 
Handling Debt Recoveries in accordance with NCLT tribunal. Drafting and vetting various Service Agreements and drafting various MOU, Letters of Intent, agreements etc. pertaining to the business.
 
Ensure that all procedures implemented by the Head Office Legal Department are duly implemented and followed within the network of CMA CGM India.
 
Provide guidance to and assist all branch offices within India how to handle issues that may translate to a legal matter.
 
Provide legal advice and otherwise assist other Departments of CMA CGM on all shipping related issues.
 
Handle loss of OB/L cases and apply Bank Guarantee procedures implemented by the Head Office Documentation Department.
 
Provide monthly reports and highlight issues that require intervention.
 
Key Performance Indicators: 
Monitor and handle court cases, appeals, writ petitions and action initiated by the authorities such as Customs, DRI, SIIB, CBEC etc.
 
Appoint and liaise with reputable surveyors and outside counsels, in coordination with the Head Office Legal Department, including negotiating and recommending reasonable expenses.
 
Make recommendation for improving claims handling process and procedures.
 
Monitor and report on Indian case law and regulations impacting on CMA CGM scope of activity.
 
Qualifications and Skill Sets: 
Minimum graduate
 
Minimum 5+ years’ experience in shipping industry and preferably with Cargo / Marine claims experience.
 
Excellent written and verbal communication.
 
Good analytical skills, good reporting skills, Trouble shooting and well verse with Ms.-office tools, especially Excel & Power point.
 
Please ensure you are familiar with the CMA CGM Corporate Internal Mobility guidelines.

Legal Counsel Senior Specialist India

Petroleum Development Oman

<div>
 
 Job Description
 
 
 
 About the Company
 
 
 Petroleum Development Oman is the leading exploration and production company in the Sultanate of Oman. The Company delivers the majority of the country's crude oil production and natural gas supply.
 
 
 Purpose of the Job
 
 
 Claim Management Specialist within the Integrated Supply Chain pays a pivotal role in ensuring the efficient handling and resolution of claims related to supply chain operations. Your responsibilities will encompass analysing, processing, and resolving claims arising from various stages of the supply chain process, collaborating with internal stakeholders, and implementing strategies to minimize future claim occurrences.
 
 
 To manage new and on-going contractor claims, provide an independent and professional support to Project Teams and ensure consistency on claims analysis across all claims prior to submission to the Claims Committee and to the STBC/TTBC, in order to safeguard the company&rsquo;s position in line with the contractual entitlements.
 
 
 Education &amp; Experience
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in Engineering, Business Administration, Economics, Finance or Commercial disciplines;
 </li>
 <li>
 7 years of experience in the Oil &amp; Gas Industry in CP roles, with at least 5 years hands-on experience in preparing and/or running contracts.
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 Proven experience (4 years) in claim management, preferably within the integrated supply chain domain.
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 Proven interpersonal, influencing and team building skills.
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 Strong CP background in the areas of strategy development, data analytics, contract management.
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 Strong understanding of supply chain processes, logistics operations, and procurement principles.
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 Excellent analytical skills with the ability to interpret data, identify trends, and draw actionable insights.
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 Effective communication and negotiation skills, with the ability to interact professionally with stakeholders at all levels.
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 Proficiency in utilizing claim management software and Microsoft Office applications.
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 Demonstrated ability to work collaboratively in a fast-paced, dynamic environment and manage competing priorities effectively.
 </li>
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 Preferred Qualifications:
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 Certification in Supply Chain Management (e.g., APICS, CSCMP) or related field.
 </li>
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 Experience with ERP systems (e.g., SAP, Oracle) and claim management modules
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 Familiarity with regulatory requirements and compliance standards relevant to the supply chain industry.
 </li>
 <li>
 Track record of driving process improvements and implementing innovative solutions in claim management practices.
 
 
 </li>
 </ul>
 
 Principle Responsibilities
 
 
 
 <ul>
 <li>
 Management of new and on-going contractor claims
 </li>
 <li>
 Support in establishment of claims prevention program to include:
 
 
 </li>
 </ul>
 i. a pre-contract award &lsquo;stress check&rsquo; for each new major contract (+500M USD) with the objective of rooting-out possible or potential &lsquo;risk areas&rsquo; for that contract and providing for safeguards and remediation to deal with those risk areas.
 
 
 ii. a 6-monthly claims-related &lsquo;health check&rsquo; for each on-going major contract, with the objective of ensuring that any claims are dealt with well before they reach critical status.
 
 
 <ul>
 <li>
 Collaborate with the Company appointed external Claims Handling Advisor (Contractor) in establishing sustainable cost effective "best practice" services relating to pro-actively prevention and management of claims through 2 phases
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 Phase 1 Claims Management Review: Contractor will support the PDO Claims Assessor in reviewing PDO&rsquo;s claims handling process and assist PDO in implementing improvements, including:
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 Contract Holders/Engineers resourcing, training and qualification.
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 tender procedures and levels of authority and empowerment.
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 claims register and reporting mechanism.
 </li>
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 record keeping and documentation.
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 protection of confidentiality and legal privilege.
 </li>
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 incorporation of lessons learnt.
 </li>
 <li>
 specific requirements and modalities for Phase 2.
 </li>
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 Phase 2 Claims Management Support and Training: Contractor will provide a "real time" claims support and training to the Claims Assessor and PDO, including supporting on:
 </li>
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 receipt, recognition, classification and logging of Claims.
 </li>
 <li>
 collation of all the relevant facts and circumstances, due diligence, review and analysis of material, preparation of case summary.
 
 
 </li>
 </ul>
 
 Skills Required
 
 
 
 Other Job Details
</div>

Claim Management Specialist (Four Years Contract)

Al Etihad Cooperative Insurance Co

<div>
 <ul>
 <li>
 Review claims according to the approved authority, verify fraud indicators, and take regulatory actions.
 </li>
 <li>
 Monitor updates on fraud indicators and methods and inform the Claims Manager and Department Managers accordingly.
 </li>
 <li>
 Review the drafting of letters and correspondence addressed to relevant authorities and approve them before being sent by department employees.
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 Review fraud indicators periodically (at least quarterly) and raise awareness among claims employees through awareness emails or workshops in coordination with the director of Claims.
 </li>
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 Follow up on daily automated escalation reports and ensure that the regulatory timeframes for processing claims are not exceeded or extend the processing period of claims as per the policies and procedures manual.
 </li>
 <li>
 Verify that the team complies with validating claims within the regulatory timeframes and according to the approved claims management policies and procedures manual.
 </li>
 <li>
 Conduct weekly follow-up on pending claims with the entities contacted to verify the validity of claims or amend liability percentages, ensuring that regulatory processing timeframes are not exceeded without taking action to extend the claim processing period.
 </li>
 <li>
 Supervise the team and ensure no discrimination in assigning tasks, authorities, or responsibilities.
 </li>
 <li>
 Supervise the team to ensure the detection and reporting of fraud cases at no less than 5% of the annual net payments.
 </li>
 <li>
 Verify that the team complies with notifying the section Claims Managers upon receiving a response from contacted entities within a maximum of one day from the date of receiving the response or decision, via email, and updating the system accordingly.
 </li>
 <li>
 Randomly select samples of all claims paid and pending by the department for internal review of the procedures applied, ensuring that the sample is no less than 5% of the total paid claims, and record all observations in an official report submitted monthly to the General Manager of Claims.
 </li>
 <li>
 If observations are detected that indicate a possible collusion or involvement of a Claims Department employee in fraudulent cases, or the leakage of critical information that contributes to such cases, a report must be submitted on the case and the suspected employee, supported with evidence, to the director of Motor Claims.
 </li>
 <li>
 Submit monthly reports to the General Manager of Claims on all claims assigned to the team, as well as a report on cases where fraudulent indicators were detected and proven.
 </li>
 </ul>
 
 
</div>

Legal Follow Up Team Supervisor

ES SUPPORT PRIVATE LIMITED

Manager - Legal (Female)Location: Gurugram, IndiaExperience: Minimum 2&ndash;4 YearsIndustry: InsurancePrior experience in managing legal matters related to MACT (Motor Accident Claims Tribunal), WC (Workmen&rsquo;s Compensation), and corporate insurance claims.We are looking for a skilled and experienced Manager - Legal to join our Corporate Claims team at TrustVerge Insurance Broker Pvt. Ltd. This role is ideal for a professional with strong expertise in MACT, WC, and corporate claims management, who can handle legal proceedings, settlement negotiations, and compliance with insurance policies and regulatory requirements.Key Responsibilities:Manage and oversee legal proceedings related to MACT (Motor Accident Claims Tribunal) and Workmen&rsquo;s Compensation (WC) claims.Coordinate with internal teams, insurers, legal counsels, and clients to ensure timely and accurate claim resolution.Prepare, review, and manage legal documentation, including claim petitions, settlement agreements, and case briefs.Handle all legal aspects of corporate insurance claims, including negotiating settlements and representing clients in legal forums.Ensure compliance with all applicable laws and regulatory requirements under IRDAI and other relevant authorities.Review and manage risk mitigation strategies and advise clients on legal aspects of claims.Maintain detailed records and MIS reports of ongoing legal cases and settlements.Provide strategic input in resolving complex claims cases and escalate as necessary.Requirements:5&ndash;10 years of experience in legal aspects of corporate claims, especially related to MACT and WCExtensive knowledge of Indian legal procedures related to Motor Accident Claims and Workmen&rsquo;s CompensationPrior experience in handling insurance claims and legal proceedings in a corporate environmentStrong negotiation skills and ability to communicate effectively with insurers, clients, and legal teamsAbility to multitask and prioritize complex cases efficientlyFemale candidates preferred.Job Type: Full-timePay: &#8377;30,000.00 - &#8377;45,000.00 per monthBenefits:<ul><li>Provident Fund</li></ul>Work Location: In person

Advocate

Gardenia Medical Centre

URGENT !!!! INSURANCE MANAGER WITH EXTENSIVE EXPERIENCE IN MEDICAL FIELD<ul><li>Oversee Insurance department</li><li>Assist in the development and implementation of insurance policies and procedures to ensure compliance with legal and regulatory requirements.</li><li>Conduct thorough analysis of insurance policies, assessing coverage limits, exclusions, and terms to provide recommendations for improvements.</li><li>in -charge in doing claims approval, claims submission and claims reconciliation.</li><li>reviewed claims monthly for coding and claim submission of insurance companies read and analyze patient records</li><li>Reconcile all the data from the system and the data gathered with original claims</li><li>Submit all the original claim forms to the manager prepare the excel sheet or patient data for claims submission</li><li>Check all medical files before submission complete and checks insurance claim forms for monthly submission determine and establishes office procedures and routines allocate subordinate's work according to departmental needs</li><li>Help maintain positive relationships with insurance carriers and clients, addressing inquiries and providing expert guidance.</li><li>With NOC</li><li>Can Start immediate</li></ul>Job Type: Full-time

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