Process Developer, Claims Admin!

Genpact

2 - 5 years

Noida

Posted: 9/3/2024

Job Description

Responsibilities


•    Assisting customer/members to lodge claims and guiding them throughout the process.
•    Registration of claims both through the online system and emails
•    Completion of claims inboxes and responding to customers enquiries via email/phones.
•    Taking immediate action when confronted with a medical emergency or made aware of a situation such as vulnerable, financial hardship etc.
•    Taking ownership of each customer contact to resolve customer issues and connect them with claim assessors when appropriate.
•    Resolving issues without or with limited management interventions.
•    Providing claim status information, benefit coverage interpretations, and explaining policy inclusions and exclusions.
•    Understanding the customer, including circumstances, problems, needs & expectations.
•    Lodging and maintaining incidents as per defined SOPs.
•    Review and process travel insurance claims in a timely and accurate manner.
•    Calculation of SAL (Single Article Limit)
•    Validating Excess and calculation of Final amount
•    Handling of Travel Curtailments
•    Handling of Cancellation & disruption 
•    Identification of Recovery (if any)
•    Evaluate claims documentation to determine eligibility and coverage.
•    Communicate with claimants, medical providers, and other relevant parties to gather necessary information and clarify details.
•    Ensure all claims are processed in compliance with company policies, procedures, and regulatory requirements.
•    Maintain detailed records of all claims and interactions.
•    Provide clear and empathetic communication to clients regarding the status of their claims.
•    Identify and investigate potential fraudulent claims.
•    Collaborate with other departments to resolve complex claims issues.
•    Stay informed about industry trends, policy changes, and regulatory updates.

About Company

Genpact is a global professional services firm delivering digital transformation by putting digital and data to work to create competitive advantage.

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