Senior Process Executive

Cognizant

1 - 4 years

1 - 2 Lacs

coimbatore

Posted:1 day ago| Platform:

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Skills Required

pre authorization individual & group policy servicing claims adjudication claims processing pre underwriting claims excellence

Work Mode

Work from Office

Job Type

Full Time

Job Description

Review incoming health insurance applications for completeness and accuracy.
Extract and validate medical information from application forms and supporting documents.
Perform initial risk assessment based on predefined underwriting guidelines.
Coordinate with internal teams to obtain missing or additional medical information.
Ensure compliance with Hong Kongs Insurance Authority (IA) regulations and data privacy laws.
Input and update underwriting decisions in the policy administration system.
Refer complex or borderline cases to senior underwriters or medical officers.
Maintain accurate documentation of underwriting decisions and rationale.
Support the issuance of policy documents post-underwriting approval.
Respond to internal queries related to underwriting status and documentation.
Participate in training sessions to stay updated on underwriting protocols.
Ensure timely processing of applications to meet service level agreements (SLAs).
Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines
Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text
Ability to succinctly collect information from a customer to set up a new claim
Ability to gather information from multiple source systems to understand and articulate the claim and what information may be needed, next steps in processing, etc.
Role & responsibilities

Preferred candidate profile

Bachelor’s degree in Life Sciences, Nursing, Healthcare Administration, or related field.
Basic understanding of medical terminology and health insurance products.
Proficiency in Microsoft Office and insurance processing systems.

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