727 Claims Processing Jobs - Page 11

Job Summary We are seeking a skilled professional with 1 to 6 years of experience in Claim Management to join our team in Insurance Claims. The ideal candidate will have strong expertise in MS Excel and excellent English language skills. This role requires working from the office during night shifts. Responsibilities Analyze and process annuity claims efficiently to ensure timely settlements. Utilize MS Excel to manage and organize claim data effectively. Collaborate with team members to resolve complex claim issues. Communicate clearly with stakeholders to provide updates on claim status. Ensure compliance with company policies and industry regulations. Identify opportunities for process improvements in claim management. Maintain accurate records of all claim transactions and communications. Provide exceptional customer service to claimants and beneficiaries. Conduct thorough investigations to validate claim authenticity. Prepare detailed reports on claim activities and outcomes. Support the team in achieving departmental goals and objectives. Stay updated with industry trends and best practices in claim management. Contribute to the companys mission by ensuring fair and accurate claim processing.

Job Description: Senior Software Engineer Guidewire-ClaimCenter Job Title: Senior Software Engineer Primary Skill: #Guidewire,#ClaimCenter Location: Hyderabad/Pune/Coimbatore Experience: 5-8 years About the job Are you a programmer who loves to design solutions to solve customers business problems? Do you enjoy guiding and mentoring a team of software developers? If yes, then this job is the perfect fit for you. We are looking for a Senior Software Engineer who has good experience in the configuration and integration of Guidewire ClaimCenter to join our team. In this role, you will work with Guidewire developers in all stages of the software development lifecycle. Responsibilities: Following are the day-to-day work activities: • Prepare and enhance design documents that would be needed to support product configuration Field mapping, Data definition, rules definition and so on • Understand product vision and expectation on technical solution architecture. • Demonstrate a strong understanding of application development projects involving the implementation of complex business rules. • Have proven technical experience in requirement analysis, detailed designs and implementation activities required to ensure the development, integration, and long-term maintenance of applications. • Expertise in configuration and development of various areas of Guidewire Integration Transactions, Job/batch configuration, Messaging, Webservices, Experience in implementing multiple LOBs, Forms Management, Administration, Account Management, Contacts and so on. • Configure, build & develop Guidewire Claim Center components using GOSU, Wizards, PCF, Data Model, GX Model definition, Workflow, Activities, etc., • Work on third party integrations for ClaimCenter. • Have previous experience with using XML, JSON, GUnit, Jenkins / GIT /TFS etc, any code coverage or code scanning tools like SonarQube. • Identify value additions that can be built as configuration components and reused on multiple projects, in order to gain efficiency / productivity. • WBS creation from User stories • Work as an individual contributor on ClaimCenter configuration and integration area. • Ensure application code is developed as per the defined architecture standards. • Sprint acceptance tracking and management. • Responsible for Sprint and Release deployments • Do thorough impact analysis and identify risks in advance. Requirements: Candidates are required to have these mandatory skills to get the eligibility of their profile assessed. The must have requirements are: • Strong technical expertise and work experience in GW ClaimCenter Integration. • Experience in GOSU scripting is a must. • Strong database skills preferably in SQL Server 2012 or ORACLE 11g. • Conversant with expansion, new development, and maintenance projects • Experience in code merging. • Experience in release deployment plan and activities. • Excellent verbal and written communication skills. • Strong analytical and problem-solving skills. • Must demonstrate clear abilities to independently work on complex technical defects/ tasks. • To be an excellent team player. • Having hands on experience on CC Configuration areas is a plus.

* Review AR claims, understand the denial reason, call the payers if required resolve the issue. *Research and interpret from the available data in billing software, EOB, MR, authorization & understand the reasons for denial/underpayment/no response. Required Candidate profile * All kinds of Denials * Strong Technical Knowledge * RCM * Authorization * Timely Filed Limit * Phyician Billing/Hospital billing * Commercial/Federal Payers * AR CALLER Contact Info - 9384813917

Mandate Skill- Duckreek Claims, Dot Net & Dot net Framework. Candidate should have strong experience in Duck Creek Claims. Candidate should have strong experience in .NET and .Net Frame work. Candidate should have knowledge Address binding Contract in services. Candidate should have knowledge of pages in FNOL process. Hands-on experience in Claims Configuration and Console modules, Configuring & Customizing Party. Hands on Exp in Module, Task Creation, Configuring/Customizing, Extension and Advanced Extension points etc. Candidate should have knowledge on customizing Automated Reserves, Process automation and Auto assignments. Good understanding of underwriting, rating, insurance rules, forms. Experience in Insurance / P&C insurance domain. Good knowledge rest and soap services. Must have excellent Communication Skills.

We will count on you for : Daily Work Management and delivery of schemes Written and Verbal communication with onshore business partners Process reporting and training Ensuring compliance of all internal and client policies Providing timely updates to AM and Onshore counterparts Driving Process improvements Assist in analyzing and evaluating Benefits data files. Review data to identify issues and discrepancies and provides resolution of errors. Maintains operation systems and tools and provides system support. Performs daily operational assignments and activities, including data analysis, system support and reporting. What you need to have? Graduate with minimum 1 year experience overall Strong health knowledge and experience in global and regional benefits Proficient with MS Word, PowerPoint, and Excel Experience in process building, best practices and/or efficiency projects Strong oral and written communication & presentation skills Good analytical skills Ability to work within a team environment Strong self-starter, fast learner, quality conscious, committed to deadlines Strong attention to detail Strong teamwork skills combined with the ability to work independently with minimal supervision. Language skills are a plus and highly desired, but not required. knowledge of H&B domain What is in it for you? Medical insurance, personal accident insurance, group term life insurance from the day you join us Holidays (As Per the location) Shared Transport (Provided the address falls in service zone) What makes you stand out? Adaptable communicator, facilitator, influencer and problem solver High attention to detail Good relationship skills, Proven ability to work on own initiative as well as in a team Adaptable communicator, facilitator and problem solver High attention to detail Ability to multi-task and prioritize time effectively

Claim registration - On Daily Basis need to register the claims which has been assigned for processing , Scrutiny of the documents Reserve Setting :- Need to do the proper reserve setting on system based on the claim documents Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions - On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard IRDAI list, Co-Payment deductions as per the policy terms and condition/ Benefit charts etc Co-ordination with Branch Offices/Clients/Hospitals for requirements - Need to have follow up with branches office/clients/hospitals for additional documents whenever require NEFT Updation - Updation of customer/insured NEFT details on system while processing the claims Travelling/Relocation - Candidate should be open for travelling whenever require for official work and also ready to relocate based on the organization or business requirement.

Job Summary Join our dynamic team as a PE-Ins Claims specialist where youll leverage your customer service skills and domain knowledge to enhance our claims processing efficiency. This hybrid role offers a unique opportunity to work in a rotational shift environment providing comprehensive support in the Property & Casualty Insurance sector. Your contributions will directly impact our service quality and customer satisfaction. Responsibilities Assist in processing insurance claims efficiently to ensure timely resolution and customer satisfaction. Collaborate with team members to analyze and verify claim information for accuracy and completeness. Utilize customer service skills to address inquiries and provide clear information to clients regarding their claims. Support the team in maintaining accurate records of claims and related documentation. Contribute to the development of process improvements to enhance claims processing efficiency. Participate in training sessions to stay updated on industry trends and company policies. Work closely with the Property & Casualty Insurance domain to understand specific claim requirements. Engage in rotational shifts to provide consistent support and coverage for claim processing. Communicate effectively with clients and stakeholders to ensure a smooth claims experience. Apply domain knowledge to identify potential issues and escalate them appropriately. Provide feedback to management on customer service improvements and claim processing enhancements. Ensure compliance with company policies and industry regulations in all claim handling activities. Foster a collaborative work environment to achieve team goals and improve service delivery. Qualifications Demonstrate strong customer service skills with a focus on client satisfaction. Possess basic understanding of the Property & Casualty Insurance domain. Exhibit excellent communication and interpersonal skills. Show ability to work effectively in a hybrid work model and rotational shifts. Display attention to detail and accuracy in claim processing. Have a proactive approach to problem-solving and process improvement. Certifications Required Customer Service Certification Property & Casualty Insurance Certification

Experience 3 to 15 years Skills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills. Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. - Grade Specific Experience 3 to 15 years Skills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills.

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606553811 / 9606557106 !!!Thanks & Regards HR TEAM!!!

Company: Sutherland Global Services Job Title: Senior Claims/Insurance Executive Position Level: L2 Employment Type: Full-Time Work Model: Brick & Mortar (On-site) Process Type: Blended Process Package: 4.0 4.5 LPA (Based on Experience & Skills) Experience Required: Minimum 2 years of relevant experience in Insurance or Claims Processing Preference will be given to candidates with Motor Claims experience Key Responsibilities: Handle end-to-end claims processing and insurance operations within a blended process model Ensure accurate and timely resolution of insurance claims in line with company policies and procedures Liaise with internal teams, clients, and insurers to gather and verify required documentation Maintain a high level of accuracy and attention to detail in claim evaluation and documentation Provide prompt responses and resolutions to queries and escalations Ensure strict compliance with industry regulations and internal standards Mandatory Requirements: Excellent communication skills in English – both written and verbal Strong understanding of insurance terms, processes, and documentation Ability to work independently and collaboratively in a fast-paced environment Proficiency in MS Office tools and digital claim processing systems Interview Process: HR Round Assessment Managerial Round Preferred Candidate Profile: Detail-oriented and organized Strong analytical and problem-solving skills Customer-focused with a professional approach Prior experience in a corporate insurance/claims environment Job Location: Unit No. 202, 2nd Floor, Campus D, Centennial Business Park, Kundalahalli Main Road, EPIP Area, Bangalore, Karnataka, India – 560066 Walkin now to be a part of a dynamic and growing team!

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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.Business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for contract conversion 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

Skill required: Talent Development - Learning Operations Designation: Learning Operations Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do Improve workforce performance and productivity, boosts business agility, increases revenue and reduces costsTalent Development processManage learning solutions, including activities such as registration, vendor management, product support, learning management system. What are we looking for Work with BI/ BP to prepare demand plan by collating training requests and working with country stakeholders, BPs.Work with BI to understand training needs and collect demand from the stakeholders and build out quarterly detailed demand plan.Conduct interviews with facilitators to assess their qualifications and expertise, and subsequently assign them to appropriate workshops based on their skillsets and experience.Conduct Train-the-Trainer (TTT) and Train-the-Backbone (TB) sessions to upskill facilitators, equipping them with the necessary knowledge and tools to effectively deliver workshops.Collaborate with the scheduling team to ensure that all session details, including session loading, enrollment, and attendance marking, were accurately updated in the Learning Management System (LMS).Collaborate with Business Partner and Stakeholders to retrieve session nominations.Manage session fill rate and handle ad hoc requests, collaborate with regional business partner, and take appropriate actions within cancellation window.Coordinate communication between facilitators and session requestors as necessary to ensure clear expectations are established regarding training delivery.Project management skills (Planning & Organizing)Working independently, accountable for deadlines, able to escalate if necessaryComfortable with ambiguity, able to provide advice and guidance when direction is not well definedConfidence/assured working with client leadership and delivering difficult messagesAbility to prioritize conflicting requirementsAbility to gather, analyze and formulate conclusions on dataPeople management skills (Coaching, listening, giving direction)Cost estimating and financial analysisStrong written and verbal communication skillsEnglish language proficiency requiredEvent planning experienceInitiative and bias for actionCritical thinking / problem solving skills Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Delivery - Actuarial Analysis Designation: I&F Decision Sci Practitioner Sr Analyst Qualifications: Bachelors in actuarial science Years of Experience: 5 to 8 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do "Data & AIActuarial analysis uses statistical models to manage financial uncertainty by making educated predictions about future events. Insurance companies, banks, government agencies, and corporations use actuarial analysis to design optimal insurance policies, retirement plans, and pension plans." What are we looking for " Actuarial Modeling Actuarial Science Insurance Claims Adaptable and flexible Commitment to quality Ability to work well in a team Agility for quick learning Written and verbal communication" Roles and Responsibilities: " In this role you are required to do analysis and solving of increasingly complex problems Your day-to-day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team" Qualification Bachelors in actuarial science

Company: Marsh Description: Ensures timely and accurate production/processing of complex documents/information (includes report preparation) Maintains a basic understanding of the core aspects of relevant Insurance and related legislation (customer awareness) and strengthen established relationships Adheres to Company policies and performance standards Contributes to the achievement of Operations team Service Level Agreements (SLA) , Key Performance Indicators (KPI) and business objectives Marsh, a business of Marsh McLennan (NYSE: MMC), is the world s top insurance broker and risk advisor. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow on LinkedIn and X.

Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(International) - Intermediate About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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 Ability to perform under pressureAdaptable and flexibleAbility to establish strong client relationshipWritten and verbal communicationPrioritization of workload 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

Description At Gigamon, our purpose is to protect the hybrid networks and data of the largest, most complex organizations on the planet. Certified as a Great Place to Work, we offer a deep observability pipeline that efficiently delivers network-derived intelligence to cloud, security, and observability tools. This helps our customers to eliminate security blind spots, optimize network traffic, and dramatically reduce tool cost and complexity, enabling them to better secure and manage their hybrid cloud infrastructure. Gigamon has served more than 4,000 customers worldwide, including over 80 percent of Fortune 100 enterprises, 9 of the 10 largest mobile network providers, and hundreds of governments and educational organizations. We are seeking a highly skilled Accountant with 5 years of experience to handle review of expenses reimbursement claims primarily focusing on USA and international entities with knowledge of international travel policy practices. This role requires proficiency in SAP Concur tool or any other tools. The ideal candidate will be proficient in managing expenses claim as per travel policy, interaction with employee for query handling, accounting and payment of claims, This role will ensure accurate processing of expense reimbursements claimed by employees, assist in month-end accounting activities and support audit processes. What you ll do: Expenses reimbursement claims processing: Accurately and timely audit the claims from employees. Ensuring compliance with company travel and other policies along with federal, state, and local tax regulations. International claims Support: Assist in processing expenses claims for international regions, ensuring all payments are processed in accordance with local laws. Employees support: Raise and respond to resolve claims related questions and discrepancies from employees of all regions, ensuring timely clarification. Expenses Accounting: Assist in recording expense claims transactions in the general ledger and the same is reconciled. Remittances: Ensure claims are timely paid to employees and accounted in accounting software. Audit Support: Help to prepare documentation and reports for internal and external audits, ensuring data integrity and compliance. Other Interaction: Work closely with third-party payroll vendors, providing data, ensuring service accuracy, and addressing any issues that arise. Also creation of vendor master in claims tool is necessary. Data Analysis: Analyze claims data for accuracy, troubleshoot issues, and support reporting efforts. What you ve done: Bachelor s or Master s degree in Accounting, Finance, Business, or a related field. Minimum 5 years of experience in expenses claims processing, with strong focus on USA and international entities. Knowledge of domestic and international travel practices and company reimbursements polices. Proficiency in tool like SAP Concur systems, accounting software and Excel. Who you are: Excellent problem-solving and analytical skills. Strong attention to detail, ensuring accuracy in data. Effective communication skills for handling employee inquiries and collaborating with teams. Experience working with multinational operations. Willingness and ability to pick up new stuff with good attitude

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview International insurance claims processing for Member claims. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Work across International business in line with service needs. Carry out other ad hoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education*: Graduate (Any) - medical, Paramedical, Pharmacy or Nursing. Experience Range* : Minimum 1 year of experience in healthcare services or processing of healthcare insurance claims. Foundational Skills- Expertise in international insurance claims processing Work Timings*: 7:30 am- 16:30 pm IST Job Location*: Bengaluru (Bangalore)

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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 dataDevelop and deliver 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 establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressureNA 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

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years Language - Ability: English - Intermediate About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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 stakeholdersAbility to perform under pressureAgility for quick learningPrioritization of workloadProblem-solving skills Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficiencies What are we looking for BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Roles and Responsibilities: Investigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Qualification BE,Diploma in Automobile

Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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.As a Travel Claims Adjuster, you will be responsible for investigating, evaluating, and processing travel insurance claims. Your role will involve assessing the validity of claims, ensuring timely and accurate resolution, and providing outstanding customer service throughout the process.- Review and process travel insurance claims, including medical, trip cancellation, and baggage loss claims. Investigate claims by gathering and analyzing relevant information and documentation. Communicate with policyholders, healthcare providers, and other stakeholders to obtain necessary information. Evaluate claims to determine coverage, validity, and appropriate compensation. Resolve disputes and provide clear explanations of claim decisions to policyholders. Maintain accurate and detailed records of claim activities and decisions. Stay updated on industry trends, regulations, and best practices. What are we looking for Claims ProcessingDetail orientationNegotiation skillsAbility to work well in a teamAdaptable and flexibleAgility for quick learning- Bachelors degree in Business, Insurance, or related field preferred. Proven experience in claims adjusting or a similar role, ideally within the travel insurance sector. Strong analytical skills and attention to detail. Excellent communication and interpersonal skills. Ability to handle multiple claims simultaneously in a fast-paced environment. Proficiency in claims management software and Microsoft Office Suite. Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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 Commercial InsuranceProperty and Casualty InsuranceProblem-solving skillsAbility to perform under pressureAbility to establish strong client relationshipAbility to work well in a teamHands-on experience with trouble-shootingInsurance ClaimsProperty and Casualty Claims Certifications: Insurance Industry Generalist Certification - Accenture Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems May create new solutions, leveraging and, where needed, adapting existing methods and procedures The person would require understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor May interact with peers and/or management levels at a client and/or within Accenture Guidance would be provided when determining methods and procedures on new assignments Decisions made by you will often impact the team in which they reside Individual would manage small 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

Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficienciesBE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership What are we looking for BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Roles and Responsibilities: Investigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Qualification BE,Diploma in Automobile

• Accurately and timely submission of medical claims to insurance companies. • Regular follow-up on unpaid or underpaid claims. • Prompt investigation and resolution of claim denials.