Analyst - Claims Excellence

As an Analyst in the Claims Excellence team, your primary responsibility will be to oversee the daily operations and ensure compliance with IA regulations. You will be managing workload distribution, monitoring team performance against SLAs, and providing guidance to processors and quality reviewers on complex claims. Resolving escalated issues and maintaining timely communication with policyholders and providers will be crucial aspects of your role. You will also play a key role in implementing process improvements to enhance claims accuracy and reduce turnaround time. Conducting regular team meetings and training sessions on regulatory updates and system enhancements will be part of your routine tasks. Additionally, you will review and approve high-value or complex claims in line with policy terms, as well as coordinate with compliance and legal teams on disputed claims and regulatory matters. Monitoring KPIs, preparing performance reports for senior management, ensuring proper documentation and audit readiness in all claims activities, and supporting recruitment and onboarding of new team members are also significant responsibilities associated with this role. Key Skills required for this position include expertise as a Claims Specialist in the healthcare domain. This is a full-time, permanent position requiring a Bachelor's Degree qualification. The job code for this role is GO/JC/740/2025. Recruiter Name: Gayathri B,