Analyst - Claims Excellence

CoimbatoreFull Time
CLAIMS SPECIALIST HEALTH CARE
Job description

Oversee daily operations of the claims excellence team ensuring adherence to IA regulations.
Manage workload distribution and monitor team performance against SLAs.
Provide guidance and support to processors and quality reviewers on complex claims.
Resolve escalated issues and ensure timely communication with policyholders and providers.
Implement process improvements to enhance claims accuracy and turnaround time.
Conduct regular team meetings and training sessions on regulatory updates and system enhancements.
Review and approve high-value or complex claims in accordance with policy terms.
Coordinate with compliance and legal teams on disputed claims and regulatory matters.
Monitor KPIs and prepare performance reports for senior management.
Ensure proper documentation and audit readiness across all claims activities.
Support recruitment and onboarding of new team members.

Skills Required
Analyst - Claims Excellence
ITES/BPO/KPO
ITES/BPO/Customer Service
Bachelor Degree
Full Time, Permanent
Key Skills
  • CLAIMS SPECIALIST
  • HEALTH CARE
Other Information
GO/JC/740/2025
Gayathri B

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