Urgent Hiring: Claims Processing Associate

Job Description

We are seeking an experienced Claims Processing professional to manage India and international employee benefits claims across multiple regions. The role involves reviewing and adjudicating reimbursement claims, validating supporting documentation, ensuring policy compliance, and maintaining service delivery standards. The ideal candidate must have hands-on claims processing experience, proficiency in Italian, and the ability to collaborate with global stakeholders.

Job Details

• Location: Mumbai

• Experience: 5–10 years

• Band: BPO 3

• Salary: Up to ₹9 LPA

• Work Mode: 100% Work From Office

• Work Schedule: Flexible shifts based on global region coverage, including 24/7 service requirements.

Requirements

• Graduate degree, preferably with a specialization in Human Resources.

• 5–6 years of hands-on experience in India and/or international claims processing and adjudication.

• Proficiency in Italian, both written and verbal, is mandatory.

• Strong knowledge of employee benefits claims, reimbursements, advances, and eligibility requirements.

• Experience processing gym, vaccination, wellness, school fee reimbursement, salary advance, and similar employee benefit claims.

• Expertise in reviewing and validating claim documentation and resolving discrepancies.

• Knowledge of Darwin and Workday is an advantage.

• Familiarity with ticket management platforms such as ServiceNow (SNOW) is preferred.

• Strong understanding of SLAs, KPIs, compliance requirements, and process improvement.

• Excellent English communication, analytical, and stakeholder management skills.

• High attention to detail and ability to manage deadlines effectively.

Key Responsibilities

Claims Processing and Adjudication

• Process and adjudicate employee benefits claims for India and international regions, including Europe, Southeast Asia, and the Middle East.

• Review and validate supporting documents for reimbursements, wellness benefits, vaccination claims, school expenses, salary advances, and other eligible claims.

• Identify discrepancies, investigate exceptions, and ensure timely resolution in accordance with established policies.

• Maintain accurate claims records and ensure consistent processing quality.

Stakeholder Management

• Coordinate with global stakeholders, internal departments, external vendors, and employees to facilitate smooth claims administration.

• Ensure claims processing practices align with regional requirements and global standards.

• Communicate claim updates, requirements, and resolutions professionally.

SLA, Compliance and Process Improvement

• Monitor and meet established SLAs, KPIs, productivity, and quality targets.

• Ensure compliance with company policies, local regulations, and international benefits administration standards.

• Identify process gaps and recommend improvements to enhance accuracy and operational efficiency.

• Maintain proper documentation and support reporting requirements.

Other Details

• Work arrangement is strictly onsite in Mumbai; work-from-home is not available.

• Shifts will depend on regional coverage requirements across a 24/7 service delivery model.

• Flexibility to work extended hours when required to meet business deadlines is essential.