Senior Claims Specialist

2 days ago


Mumbai, Maharashtra, India beBeeBusiness Full time ₹ 15,00,000 - ₹ 25,00,000
Business Analysis Expertise Required

We are seeking an accomplished Business Analyst with a strong techno-functional understanding of insurance product benefits, coverages, claims rules, exclusions and fraud analytics.

The ideal candidate will have in-depth knowledge of Product Configuration in the system, as well as a comprehensive grasp of Medical Codes ICD, PCS, and CPT codes.

Key Responsibilities:
  • Collaborate with stakeholders to gather and analyze business requirements related to claims processing.
  • Conduct thorough analysis of existing claims systems and processes, identifying areas for improvement and optimization.
  • Translate business requirements into clear technical specifications for IT development teams.
  • Understand and analyze insurance products with respect to benefits, coverages, limits, exclusions etc to optimize product configuration.
  • Develop detailed documentation of business requirements, processes, and solutions.
  • Document business process models to illustrate current and future states.
  • Identify opportunities for process improvements and contribute to ongoing optimization efforts.
  • Facilitate workshops and meetings with stakeholders to elicit and document requirements accurately.

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