2028 Claims Processing Jobs - Page 5

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.

What will youressential responsibilities include Driving the delivery of AXA XL Digital Factory application with appropriate stakeholders.Working with the all stakeholders and strategic vendor to drive the optimal and scalable delivery digital factory model. Provide management oversight, strategy and direction to digital delivery squads within the customer journey. Provide high-level organization goals and objectives. Collaborates with business stakeholders on opportunity identification issue resolution and governance. Control and manage budget for the GT spend within your span of control. Ensure the scope of services, organization model, and key processes required to deliver services are properly executed in line with the overall Factory Model. Manage relationships from Procurement - Portfolio Managers to suppliers within the Factory model. Supports delivery through escalation of risks and issues that cannot be resolved by Digital Delivery squads. Own end to end product/application delivery, support and maintenance. Define and execute actions plan for concerns raised as a result of audits. Close working relationship with Chapters to ensure the performance of the resources. In collaboration with Procurement, manages RFI/RFPs, contract negotiations and delivery of contract terms. Also manages clean termSolution Delivery Center of contracts with vendors who consistently underperform. Ensure that business cases for application investments, such as technology upgrades, productivity tools, and continuous service improvement initiatives are developed. Review and approve contracts for a predetermined level of authority. Supports delivery through escalation of risks and issues. Provides audit support for both internal and external assessments. Articulates policies and standards as appropriate and provides all required evidence on a timely basis.Owns the completion of any action plans. Ensures the Solution Delivery Center adheres to Information Security policies and standards for secure coding and manages risk acceptances.You will report to the Head of Digital Factory. Required Skills and Abilities: Significant IT and business/industry work experience in a Digital Factory Model, including experience in managing multiple, large, cross-functional teams or projects, and influencing senior level management and key stakeholders. Experience in Claims & P&C would be preferred. Demonstrable ability to solve complex problems/issues. Excellent communications skills which are adapted to different audiences and can effectively drive consensus within the Digital Factory including the Journey Owners, Product Owners and delivery team(s). Adept at vendor management, both commercially and interpersonally, with a clear understanding of Digital Factory model. Ability to articulate problems, create solutions, and present analysis with proper detail and rigor for the target audience. Thought leader in implementing agile practices with experience leading teams through change. Expert knowledge of modern application development (specifically utilizing Cloud and microservices architecture) and using agile delivery methods with a significant background in application development. Ability to design product strategy and roadmap and work within a Digital Factory. Experience with User story development, personas definition, backlog prioritization. Ability to measure the success of the product KPIs identification and tracking. Advanced experience / capability in Financial forecasting and business case justification. Must have good understanding of Agile methodology and be familiar with multiple SDLC. Previous experience leading development and delivery teams in delivering high quality, low defect solutions. Track record for metrics-driven results is a plus. Experience in planning and executing multiple complex, large scale initiatives or operational areas. Desired Skills and Abilities: Highly advanced analytical abilities with operational vision. Stakeholder management. Proven planning and organization skills, creating own work schedules, prioritizing workload, preparing in advance and setting realistic timescales. Adaptable to new/different strategies, programs, technologies, practices, cultures, etc. Comfortable with change, able to easily make transitions.

Position: Medical Officer (Doctor) - TPA for Insurance and Risk Analysis Location: Gurgaon Job Type: Full-time About Policybazaar For Business Policybazaar, the flagship platform of PB Fintech Ltd., is Indias largest online insurance marketplace, acclaimed by Frost & Sullivan. Established in 2008, Policybazaar has revolutionized insurance with unmatched awareness, choice, and transparency. Introducing Policybazaar for Business, a dedicated service designed to meet the unique insurance needs of enterprises. Launched in 2021, it offers a robust portfolio of 15+ business insurance products tailored to diverse sectors, scales, and risk profiles. Policybazaar for Business aims to fortify Indias financial ecosystem by ensuring every business is insured and worry-free. With a track record of serving over 25,000 corporates, Policybazaar for Business excels in delivering precise risk analysis and bespoke solutions. From chemicals and infrastructure to IT, renewable energy, hospitality, and logistics, Policybazaar for Business is your trusted partner in safeguarding your enterprise& future. Job Overview: We are seeking a qualified and experienced Medical Officer (Doctor) to join our team at Policybazaar for Business. This role involves using medical expertise to assist in evaluating insurance claims, conducting risk analysis, and ensuring that the medical aspects of claims are handled in accordance with industry standards and regulations. The ideal candidate will have a strong background in healthcare and an understanding of insurance policies and risk management in the medical field. Key Responsibilities: Claims Review and Evaluation: Review medical claims submitted by policyholders to ensure accuracy and compliance with insurance policies. Analyze the medical documentation provided by hospitals, clinics, and other healthcare providers to determine the legitimacy of claims. Assess the medical necessity of procedures, treatments, and hospital admissions as per the insurance policy guidelines. Provide second opinion or consultation on disputed claims or complex medical cases. Risk Assessment and Management: Perform risk assessments based on medical data and historical trends to help evaluate and manage potential risks for both policyholders and insurers. Analyze patient medical history and treatment plans to identify high-risk cases and potential fraud. Collaborate with the underwriting team to provide insights into risk factors and potential areas of concern in the policyholder pool. Medical Advisory Services: Provide expert advice and medical guidance to the TPA team, insurance providers, and policyholders regarding medical treatment, diagnoses, and claims. Act as a liaison between healthcare providers and the insurance company to ensure a seamless claims process and accurate policyholder information. Policy Development and Compliance: Assist in the development of health insurance policy guidelines to ensure they are medically sound and compliant with regulatory standards. Stay up-to-date with the latest medical trends, technologies, and regulations to ensure policies reflect current medical practices. Ensure compliance with healthcare laws and insurance industry regulations during the claims processing and risk evaluation stages. Medical Audits and Reports: Conduct medical audits to ensure the accuracy of claims and prevent fraud. Prepare detailed reports regarding the medical aspects of claims, risk assessments, and policy compliance for senior management and insurers. Collaboration with Medical Providers: Communicate with healthcare providers, hospitals, and clinics to clarify medical information and ensure proper documentation is available for claims processing. Collaborate with medical professionals in cases of complex treatments or potential discrepancies between claimed and provided medical services. Educational Qualifications: Medical degree (MBBS, MD, or equivalent) from a recognized institution. Relevant specialization (if any) is a plus (e.g., General Medicine, Surgery, etc.). Experience: Minimum of 5 years of experience in the healthcare industry, ideally in a clinical or insurance-related environment. Experience with medical claims evaluation, health insurance, or risk management is highly desirable. Familiarity with healthcare laws, regulations, and insurance policies is a plus.

Job Summary: The Business Analyst will play a key role in supporting finance and management information (MI) systems for an insurance company. The individual will bridge the gap between business operations, finance, and IT, ensuring the successful implementation and optimization of finance-related systems and management reporting tools. The role involves gathering business requirements, facilitating communication between stakeholders, and analyzing data to improve decision-making processes within the insurance domain. Key Responsibilities: Requirements Gathering: Collaborate with stakeholders (finance teams, insurance operations, and IT) to gather, document, and translate business requirements into functional specifications. Process Improvement: Identify inefficiencies in finance and reporting processes, recommending and implementing improvements to streamline workflows in the current system Data Analysis: Analyze finance and MI data of the current state systems System Implementation & Support: Support the implementation, integration, and optimization of finance and reporting systems, ensuring alignment with business processes for the new system. Reporting & MI Development: Design & Develop financial reports and dashboards using MI tools, providing detailed analysis and insights into key performance indicators (KPIs) on the new system Stakeholder Communication: Act as a liaison between finance, insurance operations, and IT teams, ensuring clear communication and alignment on project goals and timelines. Documentation: Create detailed documentation including business requirements, process flows, and functional specifications. Compliance & Risk Management: Ensure that finance and MI systems adhere to regulatory and compliance standards within the insurance industry. Required Qualifications: Bachelors degree in Finance, Accounting, Business, or a related field. Proven experience as a Business Analyst in the insurance domain, with a focus on finance and MI. Strong understanding of insurance products, underwriting, claims processes, and financial reporting. Proficiency in data analysis tools (e.g., Excel, Power BI, Tableau) Experience with Agile methodologies and familiarity with project management tools (e.g., JIRA, Confluence). Excellent problem-solving skills and the ability to analyze complex data sets. Strong communication skills to work with cross-functional teams and present findings to stakeholders. Preferred Qualifications: Experience with regulatory reporting (e.g., Solvency II, IFRS 17) in the insurance industry. Knowledge of management information systems and their role in insurance operations. Familiarity with financial modeling and forecasting techniques. Key Competencies: Analytical thinking and attention to detail. Strong business acumen with the ability to understand the financial implications of insurance operations. Ability to work in a fast-paced environment and manage multiple priorities. Collaborative mindset with the ability to influence and negotiate with stakeholders. Mandatory Key Skillsanalysis tools,confluence,jira,agile,tableau,power bi,financial modelling,business analysis,dashboards,regulatory reporting,reporting tools,agile methodology,bi,business acumen*,data analysis*,claims processing*,underwriting*,financial reporting*

Job Summary: The Business Analyst will play a key role in supporting finance and management information (MI) systems for an insurance company. The individual will bridge the gap between business operations, finance, and IT, ensuring the successful implementation and optimization of finance-related systems and management reporting tools. The role involves gathering business requirements, facilitating communication between stakeholders, and analyzing data to improve decision-making processes within the insurance domain. Key Responsibilities: Requirements Gathering: Collaborate with stakeholders (finance teams, insurance operations, and IT) to gather, document, and translate business requirements into functional specifications. Process Improvement: Identify inefficiencies in finance and reporting processes, recommending and implementing improvements to streamline workflows in the current system Data Analysis: Analyze finance and MI data of the current state systems System Implementation & Support: Support the implementation, integration, and optimization of finance and reporting systems, ensuring alignment with business processes for the new system. Reporting & MI Development: Design & Develop financial reports and dashboards using MI tools, providing detailed analysis and insights into key performance indicators (KPIs) on the new system Stakeholder Communication: Act as a liaison between finance, insurance operations, and IT teams, ensuring clear communication and alignment on project goals and timelines. Documentation: Create detailed documentation including business requirements, process flows, and functional specifications. Compliance & Risk Management: Ensure that finance and MI systems adhere to regulatory and compliance standards within the insurance industry. Required Qualifications: Bachelors degree in Finance, Accounting, Business, or a related field. Proven experience as a Business Analyst in the insurance domain, with a focus on finance and MI. Strong understanding of insurance products, underwriting, claims processes, and financial reporting. Proficiency in data analysis tools (e.g., Excel, Power BI, Tableau) Experience with Agile methodologies and familiarity with project management tools (e.g., JIRA, Confluence). Excellent problem-solving skills and the ability to analyze complex data sets. Strong communication skills to work with cross-functional teams and present findings to stakeholders. Preferred Qualifications: Experience with regulatory reporting (e.g., Solvency II, IFRS 17) in the insurance industry. Knowledge of management information systems and their role in insurance operations. Familiarity with financial modeling and forecasting techniques. Key Competencies: Analytical thinking and attention to detail. Strong business acumen with the ability to understand the financial implications of insurance operations. Ability to work in a fast-paced environment and manage multiple priorities. Collaborative mindset with the ability to influence and negotiate with stakeholders. Keywordsanalysis tools,confluence,jira,agile,tableau,power bi,financial modelling,business analysis,dashboards,regulatory reporting,reporting tools,agile methodology,bi,business acumen*,data analysis*,claims processing*,underwriting*,financial reporting*

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Job Description Position: Auto Claim Adjuster Job Title: Auto Claims Adjuster Department: Claims Reports to: Claims Manager Location: Bangalore Employment Type: Full-time Roles & Responsibilities : Dealing with Insurance Companies for Auto claims only Dealing with Location Managers for paper formalities Maintaining In-House location, Insurance companies etc. Coordinating with parent company representatives Skills & Qualifications : 1 - 3 years SOLID experience with insurance company Claims Dept or Brokerage dealing with AUTO claims / Auto Insurance only Knowledge of LOCAL Auto insurance regulatory laws Good Communication & Negotiation Skills (writing and speaking) Time flexibility requirement, and should be self-motivated Hands-on capabilities Room to Grow Bachelors degree in a related field or equivalent work experience Compensation: Fixed Salary + Incentive - 2 Rounds of interviews and joining would be immediately after the 2nd round of interviews. - Background check and verification is required. Shift - Night shift ( Canadian Timings ) 6 Days working - Sunday Off Location - Serene Building No.106, 4th Floor, 4th C Cross Rd, 5th block, Koramangala Industrial Layout, S.G. Palya, Bengaluru, Karnataka 560095 If Interested directly visit to our office location for F2F Interview Notes: If interested in auto claims then only Please apply - US/Canada process Open to freshers with strong English communication skills. Notes: If interested in auto claims then only Please apply If You have Auto claims experience, Apply Please Can attach resume to Shankar@caledontechnologies.com

As a Claims Adjudicator in the US Healthcare industry, your role will involve adjudicating US Healthcare claims under close supervision. You will be supporting other claims representatives, examiners, and leads while following process instructions to process claims efficiently. It will be your responsibility to ensure that the monthly assigned production targets are met and maintain internal and/or external accuracy standards. You will also be required to review errors marked by the Quality team and suggest a proper rebuttal version post checking the DLPs. The job may require you to work in 24x7 shifts. Qualifications Required: - Minimum Qualification: Graduate (Any discipline) - Experience: 1 to 10 years Please note that the job involves working in a fast-paced environment where attention to detail and accuracy are crucial. If you are looking to be part of a dynamic team in the US Healthcare sector, this role could be a great fit for you.,

As a Trainee Process Consultant in the International Non-Voice Process / Back Office in Navi Mumbai, you will be required to: - Learn and follow professional standards, procedures, and U.S. insurance policies. - Process claims accurately as per defined guidelines. - Ensure adherence to service levels, quality checks, and audit parameters. Qualifications required for this role: - Bachelor's degree in any field. - Excellent communication skills. - Strong attention to detail and accuracy. Join this dynamic team where you can enhance your skills and contribute to the successful processing of insurance claims.,

R1 RCM India is proud to be a Great Place To Work Certified organization which clearly states the culture and employee centric approach. Great Place To Work (GPTW) partners with more than 11,000 organizations annually across over 22 industries and assesses organizations through an employee survey on key parameters such as trust, pride, camaraderie, and fairness; and this certification puts us in the league of leading organizations for great workplace culture.R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Date: Thursday 11th Sept 25 Walk in Timings: 1:00 PM to 3:00 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Please carry a copy of Updated Resume along with Aadhaar Card and PAN Card. Desired Candidate Profile: Candidate must possess good communication skills. Only Immediate Joiners can apply. Provident Fund (PF) Deduction is mandatory from the organization worked. B. Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Candidates pursuing Regular Graduation/Post Graduation, Result awaited candidates are also not eligible. Candidate must be comfortable working with Gurgaon location . Candidate not having relevant US Healthcare experience shouldn't have more than 24 Months experience. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.

What this job involves: Analysing cash/amount received in the bank deposits and making the application against the tenant accounts Analyse and research tenant ledgers history against the over/short payments. Query handling working on all queries received and keeping a close tab on any pending queries that could be resolved and following up on the rest. Contact accountants and Property teams whenever necessary to determine the proper payment application. Research and analyse duplicate and erroneous payments. Escalate unresolved issues/concerns. Assist in training new employees as needed. Working on different process-related and ad-hoc reports Keeping all the process-related documents intact on a real-time basis Sounds like you To apply, you need to have the following: Employee Specifications Strong Finance background, Commerce graduate or Post Graduate is preferred. Minimum 0-2 years of experience in Order to Cash, specifically Cash Application role is preferable. Strong analytical skills with attention to detail and logical thinking and carry a positive attitude to develop solutions quickly Strong interpersonal skills Demonstrated consistency in values, principles, and work ethics Working knowledge of MS Office (MS Word, Excel, PowerPoint, Outlook) required Performance Objectives Works within established procedures with a moderate degree of supervision Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures, and makes sound decisions

What this job involves: Analysing cash/amount received in the bank deposits and making the application against the tenant accounts Analyse and research tenant ledgers history against the over/short payments. Query handling working on all queries received and keeping a close tab on any pending queries that could be resolved and following up on the rest. Contact accountants and Property teams whenever necessary to determine the proper payment application. Research and analyse duplicate and erroneous payments. Escalate unresolved issues/concerns. Assist in training new employees as needed. Working on different process-related and ad-hoc reports Keeping all the process-related documents intact on a real-time basis Sounds like you To apply, you need to have the following: Employee Specifications Strong Finance background, Commerce graduate or Post Graduate is preferred. Minimum 0-2 years of experience in Order to Cash, specifically Cash Application role is preferable. Strong analytical skills with attention to detail and logical thinking and carry a positive attitude to develop solutions quickly Strong interpersonal skills Demonstrated consistency in values, principles, and work ethics Working knowledge of MS Office (MS Word, Excel, PowerPoint, Outlook) required Performance Objectives Works within established procedures with a moderate degree of supervision Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures, and makes sound decisions

What this job involves: Responsibilities: Daily Cash Application. Handle mailbox for request and query management Perform daily transactions as per standard operating procedures Allocating work to the team and ensuring service delivery as agreed norms and SLAs Creation of Statement of Accounts and Refund Packets Update process documents and capture the exceptions while processing as and when required Provide support during internal/ external audits Provide new hire orientation and process training Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently Perform other duties assigned as and when required i.e. process improvement initiatives, system implementation and ad-hoc projects Sounds like you To apply, you need to have: Requirements: Ability Degree in Accounting or relevant professional accountancy qualification. Shift timings: 5:30 pm IST 02:00 am IST. Minimum 18 months of experience at current role within JLL. Preferably, 3-5 years of working experience in AR in MNC. Good knowledge of Accounts Receivable is an added advantage. Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently On-site Gurugram, HR Scheduled Weekly Hours: 40

What this job involves: Responsibilities: Daily Cash Application. Handle mailbox for request and query management Perform daily transactions as per standard operating procedures Allocating work to the team and ensuring service delivery as agreed norms and SLAs Creation of Statement of Accounts and Refund Packets Update process documents and capture the exceptions while processing as and when required Provide support during internal/ external audits Provide new hire orientation and process training Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently Perform other duties assigned as and when required i.e. process improvement initiatives, system implementation and ad-hoc projects Sounds like you To apply, you need to have: Requirements: Ability Degree in Accounting or relevant professional accountancy qualification. Shift timings: 5:30 pm IST 02:00 am IST. Minimum 18 months of experience at current role within JLL. Preferably, 3-5 years of working experience in AR in MNC. Good knowledge of Accounts Receivable is an added advantage. Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently On-site Gurugram, HR Scheduled Weekly Hours: 40

WNS Gurgaon Hiring Associates for Healthcare -Claims and Medical Billing Skills - Good communication, experience in healthcare domain, claims processing Claim Review and Processing: Reviewing claims for accuracy, completeness, and adherence to insurance policies and regulations. Verification and Eligibility: Verifying patient eligibility and insurance coverage. Education : Minimum Graduate in any field. Experience : Prior experience in healthcare claims processing, medical billing, or a related field (2 years to 3 years). RCM Mandatory Knowledge : Familiarity with medical terminology. Process : Non-Voice Location- Gurgaon Shifts-US shifts(Rotational)

Job Title - AR caller Freshers and experienced both can apply Fixed Night Shift Graduates Excellent English Communication is a must 5 Working days Retention bonus after completion of the year increments in 3 every month

Finance Analyst Accounts Receivable Client Finance - JLL Business Service (Gurugram) What this job involves: Analysing cash/amount received in the bank deposits and making the application against the tenant accounts Analyse and research tenant ledgers history against the over/short payments. Query handling working on all queries received and keeping a close tab on any pending queries that could be resolved and following up on the rest. Contact accountants and Property teams whenever necessary to determine the proper payment application. Research and analyse duplicate and erroneous payments. Escalate unresolved issues/concerns. Assist in training new employees as needed. Working on different process-related and ad-hoc reports Keeping all the process-related documents intact on a real-time basis Sounds like you To apply, you need to have the following: Employee Specifications Strong Finance background, Commerce graduate or Post Graduate is preferred. Minimum 0-2 years of experience in Order to Cash, specifically Cash Application role is preferable. Strong analytical skills with attention to detail and logical thinking and carry a positive attitude to develop solutions quickly Strong interpersonal skills Demonstrated consistency in values, principles, and work ethics Working knowledge of MS Office (MS Word, Excel, PowerPoint, Outlook) required Performance Objectives Works within established procedures with a moderate degree of supervision Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures, and makes sound decisions

What this job involves: Responsibilities: Daily Cash Application. Handle mailbox for request and query management Perform daily transactions as per standard operating procedures Allocating work to the team and ensuring service delivery as agreed norms and SLAs Creation of Statement of Accounts and Refund Packets Update process documents and capture the exceptions while processing as and when required Provide support during internal/ external audits Provide new hire orientation and process training Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently Perform other duties assigned as and when required i.e. process improvement initiatives, system implementation and ad-hoc projects Sounds like you To apply, you need to have: Requirements: Ability Degree in Accounting or relevant professional accountancy qualification. Open to all shift timings. Minimum 18 months of experience at current role within JLL. Preferably, 0-3 years of working experience in AR in MNC. Good knowledge of Accounts Receivable is an added advantage. Ability to multi-task and work in a dynamic and fast paced environment Team player and yet able to work independently.

About The Role Skill required: Reinsurance - Collections Processing Designation: Claims Management Manager Qualifications: Any Graduation Years of Experience: 13 to 18 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Canceling and rewriting insurance policies and endorsementsManage OTC collection/disputes such as debt collection, reporting on aged debt, dunning process, bad debt provisioning etc. Perform Cash Reconciliations and follow up for missing remittances, prepare refund package with accuracy and supply to clients, record all collections activities in a consistent manner as per client process (tool), delivery of process requirements to achieve key performance targets, ensure compliance to internal controls, standards, and regulations (Restricted countries). What are we looking for? Adaptable and flexibleAbility to perform under pressureProblem-solving skillsPrioritization of workloadCommitment to qualityProficient with reinsurance systems and data analytics tool (e.g., SICS, SAP, Excel and Power BI, etc.) Roles and Responsibilities: In this role you are required to identify and assess complex problems for area of responsibility The person would create solutions in situations in which analysis requires an in-depth evaluation of variable factors Requires adherence to strategic direction set by senior management when establishing near-term goals Interaction of the individual is with senior management at a client and/or within Accenture, involving matters that may require acceptance of an alternate approach Some latitude in decision-making in involved you will act independently to determine methods and procedures on new assignments Decisions individual at this role makes have a major day to day impact on area of responsibility The person manages large - medium sized teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shiftsDirect all operational processes pertaining to Reinsurance, including claims notice, collections, cash applications, premium and loss journal entries, reconciliations, and regulatory reportingLead reinsurance servicing for allocated accounts, including meticulous claims management and endorsementsEvaluate Reinsurance risks, negotiate contracts, monitor claims, and ensure all documentation aligns with industry and internal standardsLiaise with Insurers, brokers, RI markets, actuarial, finance and external partners to meet client needs, drive renewal strategies, and resolve operational challengesDrive operational excellence by reviewing, developing, and implementing process improvements, leveraging analytics and best practices to maximize efficiency and optimize outcomesSupport strategic initiatives and projects contributing to transformation, cost reduction, and adoption of digital technologiesDesign and track KPIs, analyze performance trends, identify issues, and develop actionable insights for continuous improvement Qualification Any Graduation

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for? Adaptable and flexibleAbility to perform under pressureProblem-solving skillsDetail orientationAbility to establish strong client relationship Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 14 Years to 16 Years What would you do? We are seeking a highly experienced and results-driven Claims Associate Manager with a strong background in Property & Casualty (P&C) insurance claims operations. The ideal candidate will have a minimum of 14 years of experience, including proven leadership in managing large teams (~40 FTEs) across First Notice of Loss (FNOL), claims adjudication, and payment processing functions.This role demands strong capabilities in people leadership, client relationship management, escalation handling, and cross-functional stakeholder collaboration (internal & external). The individual will be responsible for driving performance, ensuring SLA adherence, process optimization, and enhancing overall client satisfaction.Lead and oversee end-to-end P&C claims operations, including FNOL intake, adjudication, approvals/denials, and payments.Manage daily workflow, resource allocation, and workload balancing for a team of ~40 FTEs.Ensure delivery against operational KPIs, SLAs, and compliance guidelines.Provide leadership, mentoring, and performance feedback to direct reports.Handle staffing, training, and team development to build high-performing, engaged teams.Conduct regular one-on-ones, performance appraisals, and drive employee engagement initiatives.Act as the primary point of contact for client communications and service delivery discussions.Manage client escalations and ensure timely and effective resolution.Lead and oversee end-to-end P&C claims operations, including FNOL intake, adjudication, approvals/denials, and payments.Manage daily workflow, resource allocation, and workload balancing for a team of ~40 FTEs.Ensure delivery against operational KPIs, SLAs, and compliance guidelines.Provide leadership, mentoring, and performance feedback to direct reports.Handle staffing, training, and team development to build high-performing, engaged teams.Conduct regular one-on-ones, performance appraisals, and drive employee engagement initiatives.Act as the primary point of contact for client communications and service delivery discussions.Manage client escalations and ensure timely and effective resolution. What are we looking for? Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to work well in a teamExposure to US/UK P&C insurance markets.Experience in transitioning or setting up new processes or client accounts.Certification in Insurance (e.g., AIC, CPCU) or Lean/Six Sigma will be an added advantage. Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems Typically creates new solutions, leveraging and, where needed, adapting existing methods and procedures The person requires understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor or team leads Generally interacts with peers and/or management levels at a client and/or within Accenture The person should require minimal guidance when determining methods and procedures on new assignments Decisions often impact the team in which they reside and occasionally impact other teams Individual would manage medium-small sized teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for? Adaptable and flexibleAbility to perform under pressureProblem-solving skillsDetail orientationAbility to establish strong client relationship Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English - Intermediate What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataYou will be responsible for developing and delivering business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for? Ability to manage multiple stakeholders,Ability to perform under pressure,Agility for quick learning,Collaboration and interpersonal skills,Commitment to qualityAbility to manage multiple stakeholders,Ability to perform under pressure,Agility for quick learning,Collaboration and interpersonal skills,Commitment to quality Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

We are seeking for a dedicated Data Process Associate to handle claim process and join our dynamic team. As an Data entry Associate you will be responsible for processing healthcare data, ensuring accuracy, and supporting RCM process.

AR Calling.