Life and Health Insurance Claims Specialist

1 day ago

Pune, Maharashtra, India beBeeBusiness Full time ₹ 10,00,000 - ₹ 20,10,000

Insurance Claims Analyst Opportunity

We are seeking a highly skilled and experienced analyst to bridge the gap between business needs and IT solutions. The ideal candidate will have a strong understanding of insurance product benefits, coverages, claims rules, exclusions, and fraud analytics.

Key Responsibilities :

  • Collaborate with stakeholders to gather and analyze business requirements related to claims processing.
  • Conduct in-depth analysis of existing claims systems and processes, identifying areas for improvement and optimization.
  • Translate business requirements into clear and concise technical specifications for the IT development team.
  • Understand and analyze insurance products with respect to benefits, coverages, limits, exclusions etc.
  • Create detailed documentation of business requirements, processes, and solutions.
  • Develop and document business process models to illustrate current and future states.
  • Identify opportunities for process improvements and contribute to ongoing optimization efforts.
  • Perform detailed data analysis to identify trends, patterns, and potential areas of concern related to claims processing and fraud detection.
  • Develop and maintain comprehensive documentation, including functional requirements, use cases, process flows, and data mappings.

Required Skills and Qualifications :

- 7-12 years of proven experience as an analyst in the Life and Health Insurance industry.

- Proficiency in claims rules, fraud analytics, and data analysis techniques.

- Strong communication and interpersonal skills to effectively collaborate with stakeholders at all levels of the organization.

Benefits :

- Competitive compensation package.

Others :

- Opportunities for professional growth and development.

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