Claims Executive

claims processing, audits, compliance checks, and document verification

https://www.streamlinebeautyindia.com/2209

Key Responsibilities

Claims Management

• Handle end-to-end processing of insurance claims (general).
• Verify claim documents, eligibility, and policy terms.
• Coordinate with insurers, TPAs, and internal departments for claim settlements.
• Monitor claim status, follow-up for approvals, and ensure timely closure.
• Identify discrepancies, missing documents, or potential fraud indicators.

Audit & Compliance

• Conduct internal audits of claims files and documentation.
• Ensure adherence to regulatory and company compliance standards.
• Maintain audit-ready records and support external/internal audits.
• Identify process gaps and recommend improvements for risk mitigation.

Document Verification & Control

• Review and validate all claim-related documents for accuracy and completeness.
• Maintain proper filing and digital documentation as per compliance norms.
• Track and update documentation timelines, renewals, and approvals.

Reporting & Coordination

• Prepare MIS reports on claims, audit findings, compliance status, and exceptions.
• Collaborate with finance, insurers, and internal teams for clarifications.
• Support policy reviews and updates to maintain regulatory alignment.

Skills & Competencies

• Strong knowledge of claims process.
• Understanding of compliance norms and audit procedures
• Excellent document verification and analytical skills
• Attention to detail and high accuracy
• Strong communication & coordination skills
• Proficiency in MS Excel and reporting tools
• Ability to manage timelines and multitask

Qualifications

• Bachelor’s degree in Commerce, Finance, Business Administration, or related field
• 2–5 years of experience in 

  claims management, audit, or compliance

• Experience with TPA coordination will be an added advantage

Location- Gurugram sec 74A

Working days- 6 days (Two Saturday's off)

Mode- Work from Office