Executive Claims Examiner

2 weeks ago

Noida, Uttar Pradesh, India exl Full time

Job Description:

This role is responsible for reviewing and identifying different types of claim documents, verifying and updating claim information based on set requirements or procedures within the claim for various lines of business.

Key Responsibilities:

  • Review and identify various claim documents to ensure accuracy and completeness.
  • Verify and update claim information based on set requirements or procedures within the claim for various lines of business.
  • Ensure that transactions are processed as per desktop procedures to maintain quality and efficiency.
  • Participate in training initiatives to develop knowledge and stay updated on industry developments.
  • Integrate procedural changes into daily routine to ensure seamless execution.
  • Adhere to company policies and procedures to maintain high standards of quality and compliance.

Essential Functions:

  • Build and maintain strong relationships with end customers to ensure excellent service delivery.
  • Gather and analyze data to support decision-making and improve business outcomes.
  • Evaluate incoming documents, interpret necessary information, and complete assigned tasks, including indexing and filing of documents electronically on Client Provided Systems.
  • Document uploading, categorizing, and decision-making skills are essential for this role.

Primary Internal Interactions:

  • Collaborate with AM for reporting performance, escalation handling, clarifying concerns, and seeking support.
  • Work closely with Manager for settling issues left unresolved by the AM and monthly evaluation of performance.
  • Interact with Subject Matter Expert for handling process-related issues, queries, and escalated transactions.
  • Communicate with QCA for associate performance feedback and audit to update training curriculum.

Primary External Interactions:

  • Interact with Supervisors at the client end for seeking clarifications and answering queries.
  • Work with Trainers at the client end for training purposes.

Organizational Relationships:

Reports To: Assistant Manager/Lead Assistant Manager

Supervises: None

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