India Benefits Claim Adjudication

2 days ago

Mumbai Maharashtra, India Tata Consultancy Services Full time

**Walk-in |TCS Mumbai Hiring for India Benefits Claim Adjudication**.**

**Interview Date**: January 25**_th_**, 2025**

**Interview Time**: 10 AM onwards (Entry is closed at 12:30 PM)**

**Venue**: Tata Consultancy Services, Plant No 12, Gate No 4, Godrej & Boyce Complex, L B S Marg, Vikhroli West, Mumbai, Maharashtra 400079**

**Role**: Claims Processing & Adjudicator**

**Desired Experience Range**: 5-6 yrs**

**Shift**: Should be comfortable with night shift - US Hours & in a 24X7 shift environment**

**Mode of Working**: Work from Office**

**Position Overview**:
**Key Responsibilities**:

- **
Claims Processing & Adjudication**:

- 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 Impro vement**:

- 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.

**Key Skills**:

- Benefits & Reimbursement Claims Adjudication and Processing
- Knowledge of Darwin and Workday tool - Mandatory
- Documentation Validation
- Global Stakeholder Management
- Process Improvement and Compliance
- SLA & KPI Adherence
- Excellent Communication and Analytical Skills

**Working Conditions**:

- Flexible working 24*7 shift timings.
- Work from Office (No work from home)
- Agile to extended work hours when needed to meet deadlines without prompting.

Qualifications :BACHELOR OF BUSINESS ADMINISTRATION

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