Insurance Claims Processor

1 week ago

Cochin, Kerala, India Doorcaz Full time ₹ 4,20,00,000 - ₹ 6,60,00,000 per year

The Role: Senior Claims Processor

We are seeking a highly skilled and experienced Senior Claims Processor to join our dedicated Claims Management team. The ideal candidate will leverage their deep technical knowledge and substantial claims processing experience, substantiated by the prestigious Fellowship from the Insurance Institute of India (F.I.I.I.) qualification.

This role involves handling complex, high-value, and escalated claims, ensuring strict adherence to policy wordings, regulatory guidelines, and service level agreements (SLAs).

Key Responsibilities

  • Complex Claim Adjudication: Review, evaluate, and adjudicate high-value, complex, or escalated claims across [Specify Line of Business: e.g., Motor, Fire, Health, or Life] with precision and technical expertise.
  • Compliance & Audit: Ensure all claim settlements comply with the Insurance Regulatory and Development Authority of India (IRDAI) regulations, internal policies, and legal requirements.
  • Process Efficiency: Identify bottlenecks and suggest improvements in the claims workflow to enhance efficiency and customer satisfaction.
  • Mentorship & Training: Act as a subject matter expert (SME), providing guidance and training to junior claims staff on complex claims scenarios and technical matters.
  • Stakeholder Communication: Manage communication with policyholders, surveyors, loss adjusters, legal counsel, and reinsurers for smooth and timely claim resolution.
  • Fraud Detection: Conduct thorough scrutiny of documents to identify and flag potential fraudulent claims.

Qualifications & Experience

Essential Requirements

  • Education & Certification: Must possess a Fellowship (F.I.I.I.) qualification from the Insurance Institute of India (III).
  • Experience: Minimum of [Specify Number, e.g., 5-7] years of proven, hands-on experience in insurance claims processing/adjudication.
  • Technical Knowledge: Comprehensive and deep understanding of insurance principles, policy wordings, and the end-to-end claims lifecycle for [Specify Line of Business].

Desired Skills

  • Strong analytical, critical thinking, and problem-solving abilities.
  • Exceptional written and verbal communication skills in English and [Local Language, if required].
  • Proficiency in claims management software/systems and MS Office Suite.
  • Proven ability to work independently, manage high-volume workloads, and meet strict deadlines.

Benefits

  • Competitive salary and performance-based incentives.
  • Comprehensive medical and life insurance coverage.
  • Opportunities for advanced professional development and leadership training.
  • A collaborative and professionally stimulating work environment.

Job Type: Full-time

Pay: ₹35, ₹55,000.00 per month

  • Medical Insurance Claims Processor

    7 hours ago

    Cochin, Kerala, India Doorcaz Full time ₹ 5,00,000 - ₹ 12,00,000 per year

    Position SummaryWe are seeking enthusiastic MBBS freshers / interns / house-surgeons (or with up to 2 years experience) to join our medical insurance claims processing team. The role involves verifying medical documents, liaising with hospitals / TPAs / insurers, reviewing claims for accuracy and completeness, and ensuring timely processing. Clinical...

  • Claim Processor- Nurse

    2 days ago

    Cochin, Kerala, India Advenxa Pvt Full time ₹ 4,20,000 - ₹ 5,40,000 per year

    Claim Processor- NurseIndustry: BPO (Healthcare)Location: Infopark, Kakkanad, KochiExperience: Minimum of 2 years clinical experience mandatoryShift: Night Shift (6PM to 3AM)Salary: 35,000/- to 45,000/- Per MonthShould have excellent fluency in English.ResponsibilitiesProvide comprehensive clinical review of complaints and appeals filed by providers with the...

  • Insurance Claim Manager

    4 days ago

    Cochin, Kerala, India RISHIKA HR SOLUTIONS Full time ₹ 4,80,000 - ₹ 7,20,000 per year

    :Reputed Insurance Company Hiring Placement & Claims Term (Manager)Qualification - Post Graduation/GraduationExperience - 10 to 12 years Experience.Oversees the processing of insurance claims to ensure accuracy, efficiency, and compliance, supervising a team of adjusters and acting as a liaison between clients, adjusters, and other stakeholders.Salary - Up...

  • Claims Specialist

    4 days ago

    Cochin, Kerala, India Doorcaz Full time ₹ 4,20,000 - ₹ 5,40,000 per year

    We are looking for an experienced Claims Specialist with proven expertise in insurance claims processing, especially in the General Insurance sector. The ideal candidate will handle the end-to-end management of insurance claims with precision, professionalism, and strong customer orientation.Key ResponsibilitiesReview, process, and settle insurance claims...

  • Insurance Executive

    2 days ago

    Cochin, Kerala, India Sunrise Hospital Full time ₹ 3,60,000 - ₹ 7,20,000 per year

    Education Qualification: Any DegreeCollaborate with the front desk, admissions, and clinical departments to gather necessary insurance details and patient information.Verify patient insurance coverage and eligibility before services are provided.Ensure that the insurance details are accurate in the hospital's system to avoid billing errors.Prepare and submit...

  • Executive Insurance

    2 days ago

    Cochin, Kerala, India lakeshore hospital and research centre Full time ₹ 1,20,000 - ₹ 2,40,000 per year

    We are seeking a proactive and detail-oriented Insurance Executive to manage all activities related to patient insurance processes in the hospital. The ideal candidate should have prior experience in handling insurance claims, approvals, and coordination with TPAs and insurance companies.Key Responsibilities:Coordinate with patients, TPAs, and insurance...

  • Insurance Executive

    2 days ago

    Cochin, Kerala, India Otzi Synergies Private Limited Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Hiring General Insurance Underwriters & Claims Specialists (non-medical) for Kochi office on offshore basis for UAE insurer. 1–5 yrs exp, insurance qualification a plus. Attractive salary. Send CV: /

  • General Insurance

    2 weeks ago

    Cochin, Kerala, India AImploy Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    Company DescriptionAImploy is transforming recruitment through advanced AI technology, revolutionizing the way companies hire talent. The company's innovative approach streamlines the hiring process, making it more efficient and effective. By leveraging cutting-edge algorithms and machine learning, AImploy ensures that organizations can identify and attract...

  • Operation Executive – Insurance

    4 days ago

    Cochin, Kerala, India Hopezen International Private Ltd Full time ₹ 2,00,000 - ₹ 3,00,000 per year

    Job Title: Operation Executive – InsuranceLocation: Kakkanad, KochiSalary: ₹20,000 – ₹30,000 per monthExperience: 1–2 years (preferably in insurance operations/administration)Job Description:We are looking for a detail-oriented and proactive Operation Executive – Insurance to manage and support day-to-day operations. The candidate will play a key...

  • Insurance Executive

    1 week ago

    Cochin, Kerala, India EVM Citroen Full time ₹ 2,64,000 per year

    Key Responsibilities:Explain motor insurance products, policy coverage, add-ons, and renewal options to customers.Coordinate with multiple insurance companies to provide competitive quotes.Process new vehicle insurance, renewals, and endorsements.Assist customers in claim initiation, documentation, and follow-up with insurance companies.Ensure compliance...