Claims Processor and Adjudication Specialist

3 weeks ago


Bengaluru, Karnataka, India Tata Consultancy Services Full time
Job Title

Claims Processing and Adjudication Specialist

About the Role

We 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.
Stakeholder Engagement
  • 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.
SLA & KPI 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.
Policy Adherence & Process Improvement
  • 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.
Qualification & Skillset
  • 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.
Estimated Salary Range

₹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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