Specialist - Claims

4 weeks ago


mumbai, India Edelweiss Tokio Life Full time

Job Purpose

·To ensure that insurance claims are handled efficiently and that payment for valid claims are made to the nominee / beneficiary

Key Responsibilities

Responsibilities

·To handle claim assessment and control the process within TAT

·To analyze the case and trigger investigations wherever necessary

·To ensure appropriate scanning of claim documents for fraud check

·To respond to claimant queries / mails properly with prompt action

·To ensure client servicing, prompt reply, action initiation

·To ensuring payment of claim to the correct nominee/beneficiary

·To identify and mitigate the risk in discussion with manager

Specific Authorities( Financial & Non Financial)

·Investigation trigger of Claims for appropriate Assessment

·Appropriate assignment of cases to Reinsurance for Opinion

·Preparation of letters in line with Company policy

Key Performance Indicators

·Accuracy in Claims Assessment & Payout = %

·Customer Management (Email/Calls) with NPS > 50

·Managing Reporting, Compliance and Audit = %

Job Requirements

Qualifications

Graduate/Post Graduate (Preferably in Finance or Statistics)

MBA preferred

Experience

0-6 years of relevant experience

Functional Competencies

• Claims & Risk assessment

• Reporting, Compliance and audits

• Strong background in life insurance Claims

• Possesses understanding trends that affect Claims Function in insurance

Behavioral Competencies

• Good communication and interpersonal skills

• Analytical skills

• Collaboration

• Business Acumen

Key Interactions

Internal

Nature or purpose of interaction

F&A, MIS team

·Daily coordination with finance/accounts team

·Automation requirement discussion

·Data from system MIS/Reports

External

Nature or purpose of interaction

IDRA, clients

·To provide MIS/Reports to IRDA

·To understand IRDA guidelines and updates

·To meet claimant

Documented By

Lead – Lead Claims

Approved By

Head – PS/Fin Ops & Claims

HR certification By

Vice President HR


  • Specialist - Claims

    1 month ago


    Mumbai, India Edelweiss Tokio Life Full time

    Job Purpose ·To ensure that insurance claims are handled efficiently and that payment for valid claims are made to the nominee / beneficiary Key Responsibilities Responsibilities ·To handle claim assessment and control the process within TAT ·To analyze the case and trigger investigations wherever necessary ·To ensure appropriate...

  • Claim Adjudication

    1 month ago


    Navi Mumbai, Maharashtra, India INTEGRUM OUTSOURCE SOLUTIONS PVT LTD Full time

    Should possess U.S Health insurance claim processing experience - Knowledge of medical billing and coding terminologies - Ready to work in Night Shift as well as Day shift - Understanding of plan documents and general benefits - Familiarity with terms such as deductible, out of pocket, coinsurance, and copay - Strong attention to detail and accuracy -...


  • Mumbai, India Kuehne+Nagel Full time

    Collect claims documentation for marine cargo and marine liability claims by contacting internal Kuehne + Nagel and/or NACORA stations - ** Your Role **:Collect claims documentation for marine cargo and marine liability claims by contacting internal Kuehne + Nagel and/or NACORA stations to build a claim file in accordance with the SOP of each NACORA office /...


  • Mumbai, India Kuehne+Nagel Full time

    Collect claims documentation for marine cargo and marine liability claims by contacting internal Kuehne + Nagel and/or NACORA stations - ** Your Role **:Collect claims documentation for marine cargo and marine liability claims by contacting internal Kuehne + Nagel and/or NACORA stations to build a claim file in accordance with the SOP of each NACORA office /...

  • Claims Examiner

    1 week ago


    Navi Mumbai, India DECTREE INFOTECH PVT LTD Full time

    **NAME **Open Position **DEPTARTMENT**:Administration **TITLE **Claims Examiner **STATUS**:Full-time **REPORTS TO**:Manager of TPA Operations **CLASSIFICATION **Non-Exempt **JOB SUMMARY/ORGANIZATIONAL IMPACT**:Serves self-insured clients by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality...

  • Billing Specialist

    4 weeks ago


    Mumbai, India HRS Group Full time

    HRS AS A COMPANY HRS, a pioneer in business travel, aims to elevate every stay through innovative technology. With over 50 years of experience, their digital platform, driven by ProcureTech, TravelTech, and FinTech, transforms how companies and travelers Stay, Work, and Pay.  ProcureTech digitally revolutionizes lodging procurement, connecting corporations...

  • Billing Specialist

    4 weeks ago


    Mumbai, Maharashtra, India HRS Group Full time

    HRS AS A COMPANYHRS, a pioneer in business travel, aims to elevate every stay through innovative technology. With over 50 years of experience, their digital platform, driven by ProcureTech, TravelTech, and FinTech, transforms how companies and travelers Stay, Work, and Pay. ProcureTech digitally revolutionizes lodging procurement, connecting corporations and...

  • Billing Specialist

    4 weeks ago


    mumbai, India HRS Group Full time

    HRS AS A COMPANY HRS, a pioneer in business travel, aims to elevate every stay through innovative technology. With over years of experience, their digital platform, driven by ProcureTech, TravelTech, and FinTech, transforms how companies and travelers Stay, Work, and Pay. ProcureTech digitally revolutionizes lodging procurement, connecting...

  • Billing Specialist

    4 weeks ago


    Mumbai, India HRS Group Full time

    HRS AS A COMPANY HRS, a pioneer in business travel, aims to elevate every stay through innovative technology. With over years of experience, their digital platform, driven by ProcureTech, TravelTech, and FinTech, transforms how companies and travelers Stay, Work, and Pay.  ProcureTech digitally revolutionizes lodging procurement, connecting...

  • Senior Specialist

    2 weeks ago


    Mumbai, Maharashtra, India Guy Carpenter Full time

    Job Title: Senior Specialist – Transactional ServicesWhat can you expect?Strong understanding of Reinsurance principles, Reinsurance contracts and market practices.Dealing with complex Reinsurance placements, Setting up risk on system basis contract document/Broker Instruction sheets and generating covering letter (EOC) for the clientsCreating Premiums...

  • Claims Specialist

    2 weeks ago


    Mumbai, India Bytes To Bots consultancy services Full time

    Job Description:Skill: Claims_ProcessingExperience: 1 - 3yrsLocation: MumbaiNotice Period: 30days

  • Claims Specialist

    2 weeks ago


    Mumbai, India Bytes To Bots consultancy services Full time

    Job Description:Skill: Claims_ProcessingExperience: 1 - 3yrsLocation: MumbaiNotice Period: 30days

  • Claims Specialist

    2 weeks ago


    mumbai, India Bytes To Bots consultancy services Full time

    Job Description: Skill: Claims_Processing Experience: 1 - 3yrs Location: Mumbai Notice Period: 30days

  • Claims Specialist

    2 weeks ago


    mumbai, India Bytes To Bots consultancy services Full time

    Job Description:Skill: Claims_ProcessingExperience: 1 - 3yrsLocation: MumbaiNotice Period: 30days

  • Fraud Specialist I

    1 month ago


    Mumbai, India JPMorgan Chase & Co. Full time

    At Chase, you will focus on business results by offering options and finding solutions to help our customers. The Call Center Fraud Specialist's work is creative, exciting, and different every day. As a Specialist I in Fraud, you will receive approximately 80 – 100 inbound calls a day specifically regarding fraud on customer accounts. By building a...

  • Senior Specialist

    2 weeks ago


    Mumbai, India Marsh McLennan Companies Full time

    Description: Job Title: Senior Specialist – Transactional Services What can you expect? Strong understanding of Reinsurance principles, Reinsurance contracts and market practices. Dealing with complex Reinsurance placements, Setting up risk on system basis contract document/Broker Instruction sheets and generating covering letter (EOC) for...

  • Senior Specialist

    2 weeks ago


    Mumbai, India Guy Carpenter Full time

    Job Title: Senior Specialist – Transactional ServicesWhat can you expect?Strong understanding of Reinsurance principles, Reinsurance contracts and market practices.Dealing with complex Reinsurance placements, Setting up risk on system basis contract document/Broker Instruction sheets and generating covering letter (EOC) for the clientsCreating Premiums...


  • Mumbai, India Branch International Full time

    Payroll Specialist Job Overview:As a Payroll Specialist, you will work closely with the Finance and People Operations teams at Branch. Your responsibilities will include collecting and reviewing employee information and working hours, calculating wages, preparing and processing employee payments, and maintaining accurate payroll records.Roles &...

  • Tpa Executive

    1 week ago


    Chembur, Mumbai, Maharashtra, India ClaimBuddy Technologies Pvt Ltd Full time

    **Job Designation-: Insurance TPA, Medical Officer/ Claim Specialist** **Roles & Responsibilities-**: - Provide Medical opinion for Health Insurance Claims - Processing of Cashless Requests & Health Insurance Claim Documents - Proficient with medical terms & system. - Understanding of Policy terms & conditions & Various Protocols / Guidelines -...


  • Navi Mumbai, Maharashtra, India timesjobs Full time

    JOB DETAILS1 Acts as first contact point for customer claims; supports customer in notification and reception of claims, provides DGF claims documents, collects required documents from claimant and hands over to specialized claims handlers when documents are complete2 Accepts all orders (from customer or overseas office) and processes them for handover to...