9 Claims Processes Jobs

Role Overview: As a Senior Associate within Actuarial Services at PwC, you will have the opportunity to provide general insurance advice and consulting services to clients in the insurance industry. Your role will involve offering guidance on various aspects such as solvency, economic capital, risk management, mergers and acquisitions, company restructuring, financial modeling, underwriting, and compliance with new legislation. Your analytical skills will be crucial in analyzing the impact of regulatory changes on insurance companies and ensuring they have adequate reserves. Key Responsibilities: - Use feedback and reflection to enhance self-awareness and address development areas - Delegate...

Lead the delivery of customer service management solutions within the workers compensation domain, ensuring high-quality service and client satisfaction Oversee policy administration processes, optimizing workflows to enhance efficiency and accuracy Provide strategic direction for new business initiatives, aligning them with organizational goals and market demands Manage claims processes, ensuring timely and accurate resolution to support client needs and regulatory compliance Collaborate with cross-functional and cross-Geo teams to integrate customer service management with policy administration and claims operations Develop and implement best practices for workers compensation policy admin...

As the Global Practice Head for Insurance in the UK Market, your role involves driving operational excellence and transformation within the Insurance vertical. Your strategic vision and strong operational management skills will be essential in leading teams to deliver high-quality, efficient outcomes while aligning with client goals. **Key Responsibilities:** - Lead operational transformation projects such as digital asset implementation, process standardization, and benchmarking for efficiency and effectiveness. - Engage with clients to understand business needs and proactively address pain points. - Provide direction, mentorship, and development to the operations team while fostering a lea...

Role Overview: As a Cluster Relationship Manager at Niva Bupa Health Insurance Company, your role is crucial in identifying opportunities for improvement across customer service, underwriting, and claims processes. You will be responsible for ensuring a robust Management Information System (MIS) architecture for both pre-sales and post-sales activities. Collaborating with the operational team, you will co-create and implement strategies aligned with the distribution strategy of the company. Key Responsibilities: - Building relationships in the region - Reviewing performance periodically - Engaging with partners to establish operational specifications - Monitoring operations and recommending ...

As a professional in the insurance industry, you will have the responsibility of negotiating with Insurance Agencies to finalize the Terms and Conditions of Policies and Premiums. It will be your duty to ensure a smooth onboarding and renewal process with the Insurance Agencies. Your role will entail obtaining approval for all credit limits from the Insurance Agency prior to client onboarding and ensuring the timely sharing of relevant MIS files. Additionally, you will be accountable for the timely filing of NNP and claims, as well as ensuring the submission of all necessary documents for claims processing. Moreover, you will play a crucial role in setting up Standard Operating Procedures (S...

As an Insurance Claims Manager at InsuGo Insurance Brokers, you will be responsible for overseeing and processing insurance claims. Your role will involve reviewing and validating claims, offering guidance to clients, negotiating with insurers and other stakeholders, preparing reports, mentoring junior staff, maintaining accurate documentation, and compiling data for management reporting. You will review all relevant documents pertaining to claims to ensure compliance with policy terms and conditions. Providing clear and comprehensive advice to clients on the claims process will be crucial, as you guide them through claim submissions and required documentation. Resolving disputes and reachin...

You will play a crucial role in supporting various initiatives that enhance the healthcare financial experience at Zelis India. Your responsibilities will include managing the settlement of provider claims, acting as a specialist for the team. This position requires strong negotiation skills, a deep understanding of claims processes, and the ability to support and guide junior team members. Your duties will involve investigating and settling provider and client billing inquiries, including renegotiating claims to secure savings and meet or exceed department KPI goals. You will also be responsible for maintaining comprehensive tracking and documentation of all necessary information related to...

You are a qualified and experienced medical professional sought to join the insurance operations team to handle and review Group Personal Accident (GPA) and Group Mediclaim (GMC) claims. Your responsibilities include ensuring the accuracy and appropriateness of claims, resolving medical disputes, addressing client grievances, and providing expert support in claim-related discussions with insurers and clients. Your key responsibilities will involve scrutinizing GPA and GMC claims from a medical perspective, handling disputed or complex claims such as accidental disability or death due to medical or accidental causes, and liaising with insurance company doctors and TPAs to resolve disputes bas...

Role & responsibilities Oversee and manage the end-to-end claims process, ensuring timely processing and adherence to internal policies Analyze claims data to identify trends, assess process gaps, and evaluate financial impact Prepare and present reports including claim status, pending settlements, and loss projections to senior management Collaborate with internal teams and external partners to resolve operational challenges and enhance efficiency Act as the primary point of contact for claim-related insights, fostering clear communication among stakeholders Identify and implement best practices to improve claim management accuracy and efficiency