38 Claims Operations Jobs

About the Role We are looking for experienced and detail-oriented professionals to join our Claims Case Management Team . The role involves reviewing and analyzing health insurance claims, ensuring accuracy, compliance, and cost-effectiveness while maintaining a strong customer-centric approach . You will collaborate closely with hospitals, TPAs, and internal teams to identify irregularities, prevent financial losses, and uphold the integrity of the claims process . Key Responsibilities 1. Claim Review & Analysis Assess claims for admissibility, medical necessity, and identify irregularities or overbilling. Conduct root-cause analysis using claims data, treatment records, and clinical guidel...

About this role: Wells Fargo is seeking an Associate Fraud & Claims Operations Representative. In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more expe...

Experience : 8+ Years (12 Years as ASSISTANT Manager on paper) Key Requirements: Hands-on experience in End-to-End Claims (Mandatory) Strong exposure to General Liability, Auto, Motor, or Direct Insurance (US / UK markets only) Experience across multiple lines of business & ability to handle complex scenarios Excellent communication skills verbal & written Proven team management experience with knowledge of performance metrics. Do Not Consider :Candidates from Total Loss / Admin / Subrogation / Property & Casualty Insurance.

Job Description: About Us At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We're devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. Bank of...

You will be leading the Claims Operations team for US Healthcare in a fast-paced BPO environment. Your role will involve managing end-to-end claims processing operations, ensuring service excellence, maintaining compliance with client SLAs and regulatory standards, and fostering high performance within the team. Your responsibilities will include: - Managing day-to-day operations of the claims processing department, including adjudication, adjustments, rework, and quality control. - Acting as the primary point of contact for client operations teams. - Conducting regular client calls, business reviews, and performance reporting. Qualifications required for this role: - Candidates with signifi...

Role & responsibilities We are seeking an experienced and dynamic professional to lead our Claims Operations team for US Healthcare. Will be responsible for managing end-to-end claims processing operations, driving service excellence, ensuring compliance with client SLAs and regulatory standards, and leading high-performing teams in a fast-paced BPO environment. Manage day-to-day operations of the claims processing department, including adjudication, adjustments, rework, and quality control. Serve as the primary point of contact for client operations teams. Conduct regular client calls, business reviews, and performance reporting. Must Have Skillset Looking for candidates with good experienc...

As an Assistant Vice President in Specialty Insurance, your role will involve overseeing Finance & Accounting (F&A), Underwriting Support (UWS), and Claims operations for a global Specialty P&C Re/Insurance service provider. You will be leading a team of approximately 270 professionals across various functions such as RI UWS, Insurance UWS, Claims, R2R, I2C, P2P, FP&A, Tax, and Statutory Reporting. Key Responsibilities: - Provide strategic leadership across Insurance & Reinsurance UWS and F&A domains, specifically focusing on London Market operations. - Drive transformation initiatives to ensure smooth operations and deliver value to clients. - Implement tech-enabled and data-driven operatio...

Role Overview: You are invited to apply for the role of Assistant Vice President Specialty Insurance (London Market). As a niche leadership position, you will be responsible for overseeing end-to-end Finance & Accounting (F&A), Underwriting Support (UWS), and Claims operations for a global Specialty Property & Casualty Re/Insurance provider with a presence across the UK (including London Market), Europe, Bermuda, the US, and Latin America. Your role will involve managing a large span of approximately 250 professionals across various functions including RI UWS, Insurance UWS, Delegated Authority, Claims, R2R, I2C, P2P, FP&A, Tax, and Statutory Reporting for both Assumed and Ceded operations. ...

About this role: Wells Fargo is seeking a Fraud & Claims Operations Associate Manager. In this role, you will: Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention, and detection, as well as ensuring the recovery, execution, and handling of claims Identify opportunities for process improvement and risk control development in fraud and claims management to maximize efficiency and enhance customer service Make supervisory decisions and resolve issues related to work distribution under direction of fraud and claims management Leverage interpretation of internal processes and procedures to establish performance standards, evaluate perfo...

Assistant Manager / Deputy Manager - Claims -2+ Years - Pune Are you a highly motivated claims professional looking to make an impact in the insurance industry? We are seeking an experienced Assistant Manager / Deputy Manager - Claims with over 2 years of expertise in managing and processing claims. This is your chance to work in a role where you can bring value, drive process improvements, and enhance customer satisfaction. If you are ready to embark on an exciting journey of professional growth, this is the perfect opportunity for you! Location:- Pune Your Future Employer A leading organization in the insurance domain, known for its dynamic work environment and commitment to professional e...

We are seeking an experienced and dynamic professional to lead our Claims Operations team for US Healthcare Will be responsible for managing end-to-end claims processing operations, driving service excellence, ensuring compliance with client SLAs and regulatory standards, and leading high-performing teams in a fast-paced BPO environment Manage day-to-day operations of the claims processing department, including adjudication, adjustments, rework, and quality control Serve as the primary point of contact for client operations teams Conduct regular client calls, business reviews, and performance reporting Must Have Skillset Looking for candidates with good experience in Claims - managing a larg...

Communicate with customers for their insurance claims and explain the process Follow up for and verify insurance claim documents Assist customers with claim filing process and keep the claim status updated Follow up with TPA / insurers for smooth and timely claim settlement Track claims on the insurers portal. written & verbal communication/ claims knowledge/18*7 claims service policy.

Job Key Responsibilities Processing Life Insurance, and Annuities Claims for US customers. Coordinate with onshore teams and the client to ensure timely processing of Claims transactions. Managing inventory within SLAs and with accuracy Skills and Attributes Required The candidate would be required to process Life Insurance and Annuities Death Claims Good English reading/writing skills Proficient in English communication - verbal Must have Life Insurance/Annuities background, preferably death claims. Minimum 4+ years of relevant experience Ability to maintain productivity and quality standards. Proficient in SOP navigation/maintain production reports. Working in US/Canada processes would be ...

About this role: Wells Fargo is seeking an Associate Fraud & Claims Operations Representative. In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more expe...

About this role: Wells Fargo is seeking a Fraud & Claims Operations Associate Manager. In this role, you will: Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention, and detection, as well as ensuring the recovery, execution, and handling of claims Identify opportunities for process improvement and risk control development in fraud and claims management to maximize efficiency and enhance customer service Make supervisory decisions and resolve issues related to work distribution under direction of fraud and claims management Leverage interpretation of internal processes and procedures to establish performance standards, evaluate perfo...

We are looking for a highly motivated and experienced Medical Billing Supervisor to manage our daily billing and claims operations, focusing on Medicaid claims. As the Medical Billing Supervisor, you will lead the billing team, ensuring accuracy, efficiency, and compliance throughout the revenue cycle. We need a hands-on leader who can troubleshoot complex billing issues, train staff, and drive the team to achieve key performance metrics. Your responsibilities will include supervising a team of Medical Billers and Claims Specialists, distributing workloads effectively, and monitoring team performance against key metrics such as clean claim rate, denial rate, and accounts receivable aging. Yo...

Job Key Responsibilities Processing Life Insurance, and Annuities Claims for US customers. Coordinate with onshore teams and the client to ensure timely processing of Claims transactions. Managing inventory within SLAs and with accuracy Skills and Attributes Required The candidate would be required to process Life Insurance and Annuities Death Claims Good English reading/writing skills Proficient in English communication - verbal Must have Life Insurance/Annuities background, preferably death claims. Minimum 4+ years of relevant experience Ability to maintain productivity and quality standards. Proficient in SOP navigation/maintain production reports. Working in US/Canada processes would be ...

Oversee daily operations of the car insurance department, Develop and manage car insurance policies and pricing strategies, Ensure compliance with insurance laws and company standards, Handle complex claims and resolve escalated customer issues, Monitor sales performance and support agent training, Build relationships with clients, agents, and partners, Analyze market trends and recommend product improvements. Strong knowledge of insurance regulations, underwriting, and claims processes. Excellent leadership, communication, and customer service skills. Proficiency in using insurance software and CRM tools. 3-6 years of experience in car or general insurance, with at least 12 years in a manag...

Genpact is a global professional services and solutions firm committed to delivering outcomes that shape the future. With a workforce of over 125,000 individuals spread across 30+ countries, we are driven by curiosity, entrepreneurial agility, and the desire to create lasting value for our clients. Our purpose, the relentless pursuit of a world that works better for people, empowers us to serve and transform leading enterprises, including the Fortune Global 500, leveraging our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI. We are currently seeking applications for the role of Assistant Vice President, Insurance Claims Operations....

Ready to shape the future of work At Genpact, we don&rsquot just adapt to change&mdashwe drive it. AI and digital innovation are redefining industries, and we&rsquore leading the charge. Genpact&rsquos AI Gigafactory, our industry-first accelerator, is an example of how we&rsquore scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that&rsquos shaping the future, this is your moment. Genpact (NYSE: G) is...

To lead and manage the claims operations by ensuring timely, fair, and compliant claim settlements, optimizing processes for efficiency, and supporting strategic goals through data-driven decision-making and cross-functional collaboration Ensure timely and accurate settlement of claims within defined turnaround times (TATs) Maintain adherence to IRDAI regulations and internal claims policies Identify and mitigate fraudulent claims through effective investigation and controls Enhance claimant experience through transparent communication and service excellence Lead, mentor, and upskill the claims team to improve performance and accountability Optimize claim payouts and reduce leakage through d...

About this role: Wells Fargo is seeking an Associate Fraud & Claims Operations Representative In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more exper...

As the Insurance Partner Manager for Global Shared Services (GSS) at Liberty Mutual Insurance, you will play a crucial role in supporting the team based in India with governance, talent management, and strategy aligned to various Liberty Mutual Retail Market - Claims operations worldwide. Reporting to the GSS Governance and Transformation Lead, you will oversee the execution of the Enterprise-wide outsourcing workstream, ensuring consistent expectations and high-quality delivery standards from strategic partners in an onshore/offshore environment. This role, based in the Hybrid model location of Delhi NCR, requires a candidate with a Masters in business administration from a Top Tier Institu...

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we serve and transform leading enterprises, including the Fortune Global 500, with our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI. We are inviting applications for the role of Management Trainee/ Domain Trainee - P&C Insurance In this role, you will be responsible for Resource sh...

About this role: Wells Fargo is seeking a Lead Fraud & Claims Operations Representative. In this role, you will: Support performance and overall effectiveness of team as well as cross-group operational tasks Proactively provide feedback and present ideas for improving or implementing processes and tools with efficient flow of fraud and claims operations Perform or guide others on complex account activity and claims that can include high risk and high dollar transactions requiring research that involves multiple transaction channels and products Independently prioritize work and provide day-to-day work leadership and mentorship for fraud and claims team Contribute in resolving control deficie...