Akolta Solutions Private Limited is hiring Operation Executives for the USA Insurance TPA Process (Claims & Back Office). We are looking for detail-oriented and motivated professionals who can efficiently manage insurance claims, claim settlement coordination, healthcare back-office operations, and client communication.

Candidates with prior experience in US Healthcare, Medical Billing, Insurance Claims Processing, TPA Operations, Healthcare BPO, Revenue Cycle Management (RCM), or Healthcare Back Office are highly preferred.

Job Details

Job Title

Operation Executive – USA Insurance TPA Process (Claims & Back Office)

Company Name

Akolta Solutions Private Limited

Location

Gurgaon, Haryana, India

Employment Type

Full-Time

Workplace Type

On-site

Industry

Healthcare | US Healthcare | Insurance | TPA | BPO | Healthcare Operations

Salary

₹20,000 – ₹25,000 per month

Gender

Male & Female Candidates Can Apply

Shift

• Female Candidates: Day Shift
• Male Candidates: Night Shift (US Shift)

Working Days

5 Days Working

Weekly Off

2 Rotational Week Offs

Experience Required

1–5 Years

Freshers with relevant educational background and excellent communication skills may also be considered.

Education Qualification

• Bachelor’s Degree in any discipline.
• Experience in US Healthcare, Medical Billing, Insurance Claims, TPA Process, Healthcare BPO, or Back Office Operations is preferred.

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Job Description

We are looking for a proactive and detail-oriented Operation Executive to join our USA Insurance TPA Process team in Gurgaon.

The selected candidate will be responsible for processing insurance claims, coordinating claim settlements, maintaining claim documentation, communicating with insurance providers and healthcare facilities, and ensuring timely claim resolution while maintaining compliance with US healthcare standards.

Candidates should possess strong analytical skills, excellent communication abilities, attention to detail, and experience working in healthcare insurance or back-office operations.

Key Responsibilities

• Process USA insurance claims accurately and efficiently.
• Coordinate with insurance companies, TPAs, healthcare providers, and clients for claim processing and settlement.
• Review insurance claim documents for completeness, accuracy, and compliance.
• Follow up on pending claims and resolve claim-related issues.
• Verify patient insurance eligibility and policy coverage.
• Maintain accurate claim records, documentation, and operational reports.
• Handle healthcare back-office activities related to insurance processing.
• Monitor claim status and ensure timely claim settlement.
• Communicate professionally through email and phone with clients and insurance representatives.
• Ensure compliance with company policies, HIPAA guidelines, and US healthcare regulations.
• Update claim information in CRM and internal operational systems.
• Prepare MIS reports and daily operational updates for management.

Required Skills

• USA Insurance Process
• TPA Operations
• Insurance Claims Processing
• Medical Claims Settlement
• Healthcare Back Office
• US Healthcare Process
• Medical Billing
• Revenue Cycle Management (RCM)
• Claims Management
• Documentation
• MS Excel
• CRM Software
• Communication Skills
• Analytical Skills
• Attention to Detail
• Time Management
• Email Communication
• Problem Solving

Preferred Skills

• Healthcare BPO Experience
• Insurance Verification
• Claims Adjudication
• Denial Management
• AR Calling
• HIPAA Compliance
• Healthcare Operations
• Process Improvement
• Team Collaboration

Benefits

• Competitive Salary (₹20,000 – ₹25,000 per month)
• 5 Days Working
• 2 Rotational Week Offs
• Professional Work Environment
• Career Growth Opportunities
• Performance-Based Incentives
• Training & Skill Development
• Health Benefits (As per Company Policy)
• Paid Leaves
• Employee Recognition Programs

Application Process

Interested candidates should submit an updated ATS-friendly resume highlighting their experience in USA Insurance, TPA Process, Medical Billing, Insurance Claims Processing, Healthcare Operations, or Back Office Support.

Shortlisted candidates will be contacted for further interview rounds.

Contact Details

Company: Akolta Solutions Private Limited

Website: https://akolta.com
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