India Benefits Claim Adjudication

Walk-in |TCS Mumbai Hiring for India Benefits Claim Adjudication.

Interview Date: January 25th, 2025

Interview Time: 10 AM onwards (Entry is closed at 12:30 PM)

Venue: Tata Consultancy Services, Plant No 12, Gate No 4, Godrej & Boyce Complex, L B S Marg, Vikhroli West, Mumbai, Maharashtra 400079

Role: Claims Processing & Adjudicator

Desired Experience Range: 5-6 yrs

Shift: Should be comfortable with night shift - US Hours & in a 24X7 shift environment

Mode of Working: Work from Office

Position Overview:

We are seeking a skilled Senior Executive - India HRO Benefits and Claims Processing with 5–6 years of hands-on experience in managing benefits and claims adjudication with a strong focus on India-specific claims. The ideal candidate will be well-versed in various types of reimbursement claims, associated documentation requirements, and global claim processes. This role demands a meticulous professional with a strong command of English and the ability to work effectively with global stakeholders.

Key Responsibilities:

1. Claims Processing & Adjudication:
   • Efficiently process and adjudicate India-specific and global benefits claims, ensuring accuracy and compliance with policies.
   • Validate claims documentation, including reimbursements, medical claims, and other employee benefits claims.
   • Identify discrepancies in claims and ensure timely resolutions in line with company guidelines.
   • Knowledge and working experience of Darwin and workday and service now is mandatory.
2. Stakeholder Engagement:
   • Collaborate with global stakeholders to align claims processing practices with global standards.
   • Communicate effectively with internal teams, external vendors, and claimants to ensure smooth claim management.
3. SLA & KPI Management:
   • Demonstrate a strong understanding of Service Level Agreements (SLAs) and Key Performance Indicators (KPIs).
   • Consistently meet or exceed SLA requirements for claims processing while maintaining high-quality standards.
4. Policy Adherence & Process Impro vement:
   • Ensure adherence to company policies, local regulations, and international best practices in claims management.
   • Proactively identify and recommend process improvements to enhance efficiency and accuracy.

Qualification & Skillset:

• Graduate and specialization in Human resources.
• 5–6 years of experience in global HRO benefits and claims processing, with substantial exposure to India-specific claims adjudication.
• Strong understanding of various types of benefits (e.g., Health, Medical, travel, education, and other reimbursements).
• Expertise in verifying and validating claim-related documents.
• Exceptional command of English, with the ability to communicate fluently and professionally.
• Proven experience collaborating with global stakeholders across regions.
• Deep understanding of SLAs and KPIs and a track record of achieving or exceeding them.

Key Skills:

• Benefits & Reimbursement Claims Adjudication and Processing
• Knowledge of Darwin and Workday tool - Mandatory
• Documentation Validation
• Global Stakeholder Management
• Process Improvement and Compliance
• SLA & KPI Adherence
• Excellent Communication and Analytical Skills

Working Conditions:

• Flexible working 24*7 shift timings.
• Work from Office (No work from home)
• Agile to extended work hours when needed to meet deadlines without prompting.