Process Developer, Claims Admin!
Genpact
2 - 5 years
Noida
Posted: 03/09/2024
Getting a referral is 5x more effective than applying directly
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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