W | Claims operation_P

20 hours ago

Pune, Maharashtra, India Black & White Full time ₹ 60,00,000 - ₹ 80,00,000 per year


Job Title :
Senior Analyst - Claim Operations

Qualification :
Commerce Graduate

Relevant Experience :
Years and above

Must Have Skills :
Strong understanding of insurance claims processes and life cycle.
Hands-on erience with claims management systems or platforms.
Familiarity with regulatory and compliance requirements (e.g., IRDAI).
Proficiency in MS Office (especially Excel, Word, Outlook).
Excellent written and verbal communication skills.
Attention to detail and high degree of accuracy.
Analytical thinking and problem-solving skills.

Good Have Skills :
Experience in digital claims platforms or automation tools.

Roles and Responsibilities :
Process insurance claims (Health/Auto/Life/Property) in accordance with policy terms and conditions.
Validate claim documentation for accuracy and completeness.
Coordinate with internal departments (underwriting, finance, legal, customer service) for claim adjudication.
Interact with TPAs, surveyors, hospitals, or external vendors as needed for claim verification or follow-up.
Monitor claim turnaround times (TAT) and service level agreements (SLA).
Ensure regulatory and compliance guidelines (IRDAI or other regional regulators) are strictly followed.
Generate daily/weekly/monthly claim reports and support audit requests.
Identify process improvement areas to streamline claims processing and enhance customer satisfaction.
Assist in fraud detection and risk mitigation in claim handling.

Location :
Pune

CTC Range :
– 8LPA (Lakhs Per Annum)

Notice Period :
to 30 days

Mode of Interview :
Face To Face

Shift Timing :
Night shift

Mode of Work :
Hybrid

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