Analyst - Claims Excellence
HyderabadFull 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
