4 Policy Interpretation Jobs

Genpact is a global professional services and solutions firm committed to shaping the future through the relentless pursuit of a world that works better for people. With over 125,000 employees in 30+ countries, we serve and transform leading enterprises, including Fortune Global 500 companies, by leveraging our deep industry knowledge, digital operations services, and expertise in data, technology, and AI. As a Senior Associate in the Automotive OEM Insurance business unit within the North American Property & Casualty insurance vertical at Genpact, you will be responsible for processing auto insurance claims for our clients. Reporting directly to the Supervisor of Auto Insurance Claims, your role will encompass policy interpretation, coverage analysis, customer service, negotiation, and contract support. It is essential to have experience in handling multiple projects simultaneously while adhering to deadlines. Your responsibilities will include reviewing, analyzing, negotiating, and adjusting complex primary and excess liability claims, as well as physical damage, collision, and comprehensive claims. You will be involved in settlement/disposition of claims, preparing coverage correspondence, and communicating with internal and external partners regarding claim status and updates. Building relationships with brokers, risk managers, and vendors, managing outside counsel, and providing guidance to junior staff members are also key aspects of the role. To qualify for this position, you must have a Bachelor's degree or equivalent, with a law degree being preferred. A minimum of three years of experience in handling automobile liability, physical damage, or personal injury protection claims is required. Experience in the automotive industry or familiarity with automotive dealer associations and OEM programs is highly desirable. Strong analytical, organizational, time management, and communication skills are essential, along with proficiency in Microsoft Office applications. The ability to handle large volumes of files, work overtime during peak periods, and maintain a positive attitude while delivering excellent customer service is crucial. If you are a team player who is flexible, adaptable, and committed to ethical standards and integrity, we invite you to join Genpact as a Consultant - Claims 4A at our Gurugram location. This is a full-time, regular position that offers the opportunity to contribute to our claims practice and make a meaningful impact in the industry.,

Global University Systems is an international education group committed to empowering students to enhance their lives through education. Education is viewed as a catalyst for advancing careers, lives, and society, paving the way for a brighter future for all. With a network of 30 institutions across the globe, we offer a diverse range of industry-relevant skills through inclusive, accessible, and digital-first learning. Currently, we educate approximately 122,000 students globally, with over 20 million unique subscribers to our courses. Our global ecosystem is dedicated to facilitating accessible digital learning and academic achievement. In this role at Global University Systems, you will lead the IBD Compliance Team for all institutions within the IBD department. Your primary focus will be on supporting strategic compliance objectives and enhancing the performance of the overall compliance team. As the Global Compliance HOD, your responsibilities will include assessing and monitoring risks associated with Recruitment Partners. You will be tasked with developing and implementing a comprehensive vendor risk and regulatory compliance program for the organization. This program will involve maintaining Partner risk profiles, conducting ongoing monitoring activities, and providing regular updates to senior management. Collaboration with various business units is essential to ensure that Partners are appropriately vetted, that effective risk mitigation strategies are in place, and to prepare regulatory-compliant materials for senior management and the Institutional Compliance team. Key responsibilities will involve: - Investigating disparities, suspicious activities, and patterns leading to inconsistencies - Developing and implementing a Recruitment Partner risk management and compliance program - Conducting Recruitment Partner risk assessments to identify potential risks and vulnerabilities - Analyzing Recruitment Partner risk profiles and devising risk mitigation strategies - Developing and maintaining Recruitment Partner risk management policies and procedures - Conducting ongoing monitoring activities to ensure compliance with Recruitment Partner risk management policies - Collaborating with Institutional Compliance and other business units to ensure compliance with Recruitment Partner due diligence and risk management requirements - Identifying and escalating emerging risks to senior management - Leading the development, implementation, and communication of Recruitment Partner compliance and risk policies and procedures - Acting as a subject matter expert in the operational risk framework and risks/processes/controls - Maintaining a strong understanding of current business and function risks - Establishing and maintaining effective relationships with internal and external stakeholders Requirements: - Bachelor's degree in business, finance, or a related field - 10+ years of experience in operational risk management, Recruitment Partner risk management, or related fields - Experience with vendor risk management and/or vendor compliance tools and technologies - Relevant certifications such as CTPRP and SCMP - Strong project management skills - Ability to interpret regulations and policies - Proficiency in Recruitment Partner risk management frameworks and best practices - Excellent communication skills and ability to collaborate effectively with stakeholders - Strong analytical skills and attention to detail - Ability to work well in a fast-paced environment Additional Information: This position is available only under our Consultancy Agreement. We appreciate your interest in Global University Systems and will carefully review all applications to identify candidates whose qualifications align with our requirements. If selected to proceed to the next stage of the recruitment process, we will contact you. Please submit your CV in English for consideration. We wish you success in your application.,

Role & responsibilities: Act as the primary contact for assigned clients for all Non-EB claims. Handle the entire claims lifecycle from claim notification, documentation, insurer liaison, to settlement. Coordinate effectively with surveyors and ensure timely surveys and report submissions. Interpret policy wordings accurately and ensure settlements are aligned with coverage. Maintain detailed claim MIS, trackers, and dashboards with zero discrepancy. Regularly update clients on claim progress, documentation status, and final closure. Ensure high levels of customer satisfaction through professional service and problem resolution. Proactively escalate complex or high-value claims and provide resolution plans. Conduct claim review meetings, prepare reports for internal and external stakeholders. Support the business development team by showcasing claims capability to clients. Ensure all claims handled are compliant with IRDAI and internal audit norms. Lead, guide, and mentor junior team members. Key Requirements: Proven experience in handling general insurance claims (Fire, Engineering, Marine, Liability, etc.). Strong knowledge of policy coverage, clauses, and regulatory compliance. Excellent communication and client handling skills. Strong coordination skills with surveyors, loss assessors, and insurers. Analytical mindset with high attention to detail. Proficiency in Excel and claim management tools. Ability to handle high-pressure situations and complex claims independently.

Experienced and licensed medical professional (MBBS/MD) with a strong background in medical claims assessment and clinical evaluation within the health insurance or TPA industry. Skilled in reviewing pre-authorization requests, hospitalization claims, and medical documentation to ensure medical necessity, policy compliance, and regulatory standards (IRDAI). Proficient in ICD-10 coding, claims adjudication, and fraud detection, with a focus on accuracy, ethical judgment, and collaborative decision-making. Adept at coordinating with hospitals, TPAs, and internal teams to streamline claim processing and maintain service quality.