Claims Processor and Adjudication Specialist
3 weeks ago
Claims Processing and Adjudication Specialist
About the RoleWe are seeking a skilled Senior Executive - India HRO Benefits and Claims Processing with 5–6 years of hands-on experience in managing benefits and claims adjudication with a strong focus on India-specific claims. This role demands a meticulous professional with a strong command of English and the ability to work effectively with global stakeholders.
Key Responsibilities- Efficiently process and adjudicate India-specific and global benefits claims, ensuring accuracy and compliance with policies.
- Validate claims documentation, including reimbursements, medical claims, and other employee benefits claims.
- Identify discrepancies in claims and ensure timely resolutions in line with company guidelines
- Knowledge and working experience of Darwin and Workday and Service Now is mandatory.
- Collaborate with global stakeholders to align claims processing practices with global standards.
- Communicate effectively with internal teams, external vendors, and claimants to ensure smooth claim management.
- Demonstrate a strong understanding of Service Level Agreements (SLAs) and Key Performance Indicators (KPIs).
- Consistently meet or exceed SLA requirements for claims processing while maintaining high-quality standards.
- Ensure adherence to company policies, local regulations, and international best practices in claims management.
- Proactively identify and recommend process improvements to enhance efficiency and accuracy.
- Graduate and specialization in Human resources
- 5–6 years of experience in global HRO benefits and claims processing, with substantial exposure to India-specific claims adjudication.
- Strong understanding of various types of benefits (e.g., Health, Medical, travel, education, and other reimbursements).
- Expertise in verifying and validating claim-related documents.
- Exceptional command of English, with the ability to communicate fluently and professionally.
- Proven experience collaborating with global stakeholders across regions.
- Deep understanding of SLAs and KPIs and a track record of achieving or exceeding them.
₹800,000 - ₹1,200,000 per annum
Work Environment- Flexible working hours with the possibility of extended work hours when needed.
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