Senior Executive – India & Global HRO Benefits and Claims Processing

Location: Mumbai, Maharashtra
Experience: 5–10 Years
Band: BPO 3
Salary: Up to ₹9 LPA
Job Code: 436492
Work Mode: Work From Office (WFO)
Shift: Rotational / Geography-Based Shifts (24×7 Service Delivery)

Job Overview

We are looking for an experienced Senior Executive – India & Global HRO Benefits and Claims Processing to manage benefits-related claims processing and adjudication for employees across India and international regions, including Europe, Southeast Asia, and the Middle East.

The ideal candidate will have hands-on experience in claims processing, reimbursement validation, benefits administration, and policy compliance. Strong English communication, analytical skills, attention to detail, and the ability to coordinate with global stakeholders are essential.

Italian language proficiency (written and verbal) is listed as a key skill requirement. Candidates should be prepared to work from the Mumbai office and support a 24×7 service delivery environment, including extended hours when required.

Key Responsibilities

1. Claims Processing and Adjudication

• Process and adjudicate India-specific and international employee benefits claims accurately and within defined timelines.

• Review and validate supporting documents for various claims, reimbursements, and employee advances.

• Handle claims such as:

  • Gym and fitness reimbursements

  • Vaccination claims

  • Wellbeing benefits

  • School and education reimbursements

  • Salary advances

  • Other employee benefits and reimbursement claims

• Verify claim eligibility against company policies, benefit guidelines, and applicable regional requirements.

• Identify discrepancies, missing documents, duplicate claims, and potential processing errors.

• Resolve claim-related issues and ensure timely, accurate outcomes.

• Maintain complete records and documentation for audit and reporting purposes.

2. Global Stakeholder Management

• Coordinate with global HR teams, internal stakeholders, external vendors, and employees across multiple regions.

• Respond to claim-related queries and provide clear, professional updates on claim status and requirements.

• Support consistent claims-processing practices across India, Europe, Southeast Asia, and the Middle East.

• Escalate complex cases and policy-related issues to the appropriate teams.

• Communicate effectively in English and use Italian language skills where required.

3. SLA and KPI Management

• Meet established service-level agreements (SLAs), turnaround times (TATs), productivity targets, and quality standards.

• Monitor processing accuracy, pending claims, ageing cases, and resolution timelines.

• Maintain accurate reports and provide updates on operational performance.

• Identify recurring delays and take corrective action to improve service delivery.

4. Policy Compliance and Process Improvement

• Ensure claims are processed in accordance with company policies, regional benefit guidelines, and applicable regulations.

• Identify process gaps, recurring errors, and opportunities to improve accuracy and efficiency.

• Recommend process improvements, standardization, and workflow enhancements.

• Participate in quality reviews, audits, knowledge-sharing sessions, and continuous-improvement initiatives.

5. Systems and Documentation

• Use relevant HR systems and ticket management tools to process claims and manage employee queries.

• Maintain accurate case notes, claim records, supporting documentation, and audit trails.

• Work with systems such as Darwin, Workday, and ServiceNow (SNOW), where applicable.

• Follow standard operating procedures and data-confidentiality requirements.

Required Qualifications

• Graduate degree; specialization in Human Resources is preferred or required as per the hiring policy.

• 5–10 years of overall experience, with 5–6 years of relevant claims processing and adjudication experience preferred.

• Hands-on experience in India and/or international employee benefits claims processing.

• Experience validating claim documentation, reimbursements, advances, and benefit eligibility.

• Strong understanding of SLAs, KPIs, quality standards, and turnaround-time requirements.

• Excellent written and verbal English communication.

• Italian language proficiency in both written and verbal communication, as specified in the key skills.

• Strong analytical, problem-solving, documentation, and stakeholder-management skills.

Preferred Skills

• Experience with Darwin and Workday.

• Knowledge of ServiceNow (SNOW) or other ticket management tools.

• Experience supporting global HR operations and employee benefits processes.

• Knowledge of regional benefits policies and reimbursement practices.

• Experience in process improvement, compliance, and audit support.

Key Competencies

• Claims Processing and Adjudication

• Employee Benefits Administration

• Documentation Verification and Validation

• Reimbursement and Salary Advance Processing

• Global Stakeholder Management

• SLA, KPI, and TAT Management

• HR Systems and Case Management

• Policy Compliance and Audit Readiness

• Analytical and Problem-Solving Skills

• Attention to Detail

• Professional Communication

• Process Improvement

Working Conditions

• Work Mode: Work From Office (WFO) – Mumbai.

• Shift: Based on regional coverage requirements within a 24×7 service delivery environment.

• Flexibility to work extended hours when required to meet operational deadlines.

• Ability to coordinate with global teams across different time zones.

Important Eligibility Information

• Ex-TCS employees are not eligible to apply.

• PAN and Date of Birth (DOB) are required for profile creation.

• Candidates must have relevant claims processing and adjudication experience.

• Italian language proficiency is specified as a key skill and should be validated during screening.

• Candidates must be comfortable with the Mumbai WFO requirement and shift flexibility.