CLAIMS ADJUSTMENT SPECIALIST

4 days ago

bangalore, India ADP Full time

Job Description : CLAIMS ADJUSTMENT SPECIALIST Responsibilities: The Claim Adjustment Specialist is responsible for end-to-end validation, reviewing and responding to all requests and questions with respect to Risk Management-related issues which include workers’ compensation claims. Provide direct assistance on all claim-related questions or requests. Take ownership of the question or request and ensure the question or request is properly handled or documented. Coordinate with TPA on claim issues and concerns while providing claim oversight. Accurately document claim activities and maintain up to date records in claim management system. Review claim forms, supporting documents and customer information. Validate claim eligibility based on policy coverage, limits and conditions. Identify discrepancies, missing information or fraud indicators. Meet TAT, accuracy and SLA targets. Skills Required: Strong Analytical skills and attention to detail Attention to detail Excellent Communication skills Preferred Experience: 1-2 years of experience in Claims Management or Claims processing is mandatory

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