Claims Processing Associate
Job Description
Senior Executive - India HRO Benefits and Claims Processing
Location: Mumbai
Experience: 5–10 Years
Position Overview
We are seeking an experienced Senior Executive for India HRO Benefits and Claims Processing with hands-on experience in claims processing and adjudication across India and international regions. The ideal candidate should have a strong understanding of employee benefits, reimbursements, claims documentation, and policy compliance, along with excellent English communication skills and the ability to collaborate with global stakeholders.
Proficiency in Italian, both written and verbal, is required for this role.
Key Responsibilities
1. Claims Processing and Adjudication
Process and adjudicate India-specific and international employee benefits claims accurately and efficiently.
Review and validate documentation for gym reimbursements, vaccination claims, wellbeing benefits, school reimbursements, salary advances, and other employee benefits.
Identify discrepancies, resolve claim-related issues, and ensure timely processing in accordance with company policies.
Maintain accurate records and ensure compliance with applicable guidelines.
2. Stakeholder Management
Collaborate with global stakeholders across India, Europe, Southeast Asia, the Middle East, and other regions.
Coordinate with internal teams, external vendors, and claimants to ensure smooth claims management.
Communicate professionally and effectively to resolve queries and provide timely updates.
3. SLA and KPI Management
Maintain a strong understanding of Service Level Agreements (SLAs) and Key Performance Indicators (KPIs).
Meet established turnaround times, productivity targets, and quality standards.
Monitor processing accuracy and contribute to continuous service delivery improvements.
4. Policy Compliance and Process Improvement
Ensure adherence to company policies, regional regulations, and international best practices.
Identify process gaps and recommend improvements to enhance operational efficiency and accuracy.
Maintain confidentiality and accuracy while handling employee benefits and claims information.
Qualifications and Skills
Graduate degree; specialization in Human Resources is preferred.
5–10 years of overall experience, with relevant hands-on experience in India and/or global claims processing and adjudication.
Strong knowledge of employee benefits, reimbursements, salary advances, and claims eligibility.
Proficiency in Italian, both written and verbal.
Excellent documentation verification and validation skills.
Knowledge of Darwin and Workday is an advantage.
Familiarity with ServiceNow (SNOW) or other ticket management tools is an advantage.
Strong analytical, problem-solving, and communication skills.
Experience working with global stakeholders and meeting SLA/KPI targets.
Working Conditions
Work from Office (Mumbai); work from home is not available.
Shifts may vary depending on regional coverage requirements across a 24×7 service delivery environment.
Flexibility to work extended hours when required to meet business deadlines.
Important Eligibility Criteria
Former TCS employees are not eligible to apply.
PAN and Date of Birth (DOB) are mandatory for candidate profile creation.
Key Skills
7 SkillsRole Specifications
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Gratitude Inc is a global company with presence across APAC, Africa, and USA. We are known for our people, innovation and customer focused approach.
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