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5.0 - 9.0 years
0 Lacs
karnataka
On-site
Join our team as a Subject Matter Expert in Claims HC where you will leverage your expertise in Facets Claims and Claims Adjudication to optimize our claims processing systems. With a focus on Dental and Commercial Claims you will play a pivotal role in enhancing operational efficiency and ensuring compliance with industry standards. This office-based role offers the opportunity to work in a dynamic environment contributing to impactful projects that benefit both the company and society. Lead the analysis and optimization of claims processing workflows to enhance efficiency and accuracy. Oversee the implementation of Facets Claims and Claims Adjudication systems to ensure seamless integration and functionality. Provide expert guidance on Dental and Commercial Claims processes to ensure compliance with industry standards. Collaborate with cross-functional teams to identify and resolve system issues improving overall operational performance. Develop and maintain documentation for claims processing procedures to support training and knowledge sharing. Monitor and evaluate system performance recommending improvements to enhance service delivery. Conduct regular audits of claims processes to ensure adherence to regulatory requirements and company policies. Facilitate training sessions for team members to enhance their understanding of claims systems and processes. Analyze data trends to identify opportunities for process improvements and cost savings. Support the development of new claims processing initiatives to drive innovation and efficiency. Communicate effectively with stakeholders to provide updates on project progress and system enhancements. Ensure that all claims processing activities align with the company's strategic goals and objectives. Contribute to the development of best practices for claims management to support continuous improvement. Qualifications: - Demonstrate proficiency in Facets Claims and Claims Adjudication with a strong understanding of system functionalities. - Possess in-depth knowledge of Dental and Commercial Claims processes and industry standards. - Exhibit excellent analytical skills to identify and resolve complex system issues. - Show strong communication skills in English both written and verbal to effectively collaborate with team members. - Display a proactive approach to problem-solving and process improvement. - Have a minimum of 5 years of experience in claims processing with a focus on Dental and Commercial Claims. - Be able to work independently and manage multiple tasks in a fast-paced environment. Certifications Required: - Certified Professional Coder (CPC) or equivalent certification in claims processing.,
Posted 3 weeks ago
5.0 - 10.0 years
5 - 10 Lacs
Kolkata
Work from Office
1.Oversee claims process - commercial insurance products (Fire, Marine, Property) 2.Interpret insurance policy language to determine coverage 3.Conduct investigations to establish facts and assess damages. 4.Identify potential fraudulent claims. Required Candidate profile Handles the process of managing commercial insurance claims, from initial notification to settlement.
Posted 1 month ago
3.0 - 8.0 years
2 - 6 Lacs
Noida
Work from Office
Urgent Hiring_ SME (Only Immediate Joiners) for Property & Casualty Insurance with a leading International Bpo @ Noida Location. SME - Graduate with minimum 3.5-5 years of work experience Skill - P&C Insurance Domain Shift - US Night Shift Work Type - Work From Office Location - Noida, Sector 135 Ctc- Max 6.5 Lpa Apply- rohita.robert@adecco.com ESSENTIAL SKILLS/PERSONALITY TRAITS: Resources executing day to day activities of the engagement Strong analytical, logical and data management skills preferred Service Excellence orientation MS Office Skills Basic keyboarding skills and computer skills of data entry Personal effectiveness skills Prioritizes and tracks own activities Follows documented processes Documentation of own work on a daily basis Interpersonal skills Strive to understand and resolve issues/queries at the first instant Keeps own work aligned with teams requirements
Posted 2 months ago
5.0 - 10.0 years
10 - 18 Lacs
chennai
Work from Office
Timely settlement of assigned claims Effectively coordinating between client / branch office / insurer / surveyor to ensure timely resolution of non-EB claims within Company defined TATs Handling day-to day servicing requirements of claims on a timely basis to ensure complete customer satisfaction Effectively managing the team of Executives who may report to him / her Ensuring that all required MIS reports are updated and submitted on a timely basis Ensuring compliance with IRDA requirements in respect of claims management Maintaining excellent relationships with insurers / surveyors to ensure support for claims settlement Ensuring that all operational requirements / processes are met as per Company defined TAT Excellent knowledge of general insurance products (property and marine are mandatory) to enable settlement of claims related to the same Prior experience at insurer / insurance broking firm / surveyor Existing relationships with claims settlement teams at PSU Insurance companies / surveyors (D) Able to deal with / handle the requirements of large corporates Proactive in handling customer needs Multi-tasking & prioritizing Strong interpersonal skills Excellent communication skills Abreast with technology
Posted Date not available
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