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Fulcrum Digital
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Operations Support - Claims (Rockville)

Operations Support - Claims (Rockville)

Fulcrum Digital

0 years

0 Lacs

Pune, Maharashtra

Posted:1 month ago| Platform: SimplyHired logo

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Skills Required

Communication skills

Work Mode

On-site

Job Description

Who are we
Fulcrum Digital is an agile and next-generation digital accelerating company providing digital transformation and technology services right from ideation to implementation.

These services have applicability across a variety of Industry including banking & financial services, insurance, retail, higher education, food, healthcare, and manufacturing. Headquartered in the bustling city of New Jersey, Fulcrum was rated among the fastest growing Software Companies in Inc 5000 Club and No. 7 Technology firm in New Jersey by NJ Biz.

Our team of business and technical consultants are spread across the US and other regions including the UK, Portugal, LATAM, Australia, and Finland where we have our operations.

The Role

Must have experience in insurance Domain, Property & Casualty, medical health Claims processing and Operations.
Create, update, and maintain operations / SOP documents and access systems on behalf of the Claims leadership group and provide the right data to them.
Need ability to operate effectively at all levels, from managing front line employees to interacting with executives.
Demonstrate ability to identify and implement efficiencies within an operations environment.
Need ability to manage operational inventory to meet stated Service Level Agreements.
Ensure that all activity is properly documented within the appropriate Client system.
Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement.
Manage and process claims related to property damage, personal injury, and liability.
Investigate the validity of claims, assess coverage, and ensure accurate settlement outcomes.
Collaborate with adjusters, legal teams, and clients to resolve claims efficiently.
Review policy details with clients to ensure clear understanding and compliance.
Maintain accurate records of policies, claims, communications, and necessary documentation.

Requirements

Good verbal and written communication skills.
Knowledge on how to use claims processing tools like File Handler
Must be able to communicate with onsite people.
Working knowledge of Medical health claims processing.
Experience in working for medical stop loss and healthcare industry for US Clients
Need ability to operate effectively at all levels, from managing front line employees to interacting with executives
Demonstrate ability to identify and implement efficiencies within an operations environment
Need ability to manage operational inventory to meet stated Service Level Agreements
Ensure that all activity is properly documented within the appropriate Client system
Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement

Job Opening ID

RRF_5424

Job Type

Permanent

Industry

IT Services

Date Opened

20/06/2025

City

Pune

Province

Maharashtra

Country

India

Postal Code

411057

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Operations Support - Claims (Rockville)