Senior Executive - India HRO Benefits and Claims Processing | Mumbai | 5-10 Yrs | Up to 9 LPA

Role: Claims - Senior Executive

Location: Mumbai, India

Experience: 5 - 10 Years

Band: BPO 3

Salary: Up to 9 LPA

Job Code: 436492

Job Type: Full-time | Work From Office

Shift: Dependent on geography / region coverage | 24x7 Service Delivery

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 claims adjudication and processing, with a strong focus on India and International claims processing.

The ideal candidate will be well-versed in various types of claim processing for global regions (India, Europe, SE Asia, Middle East, etc.) and will be a meticulous professional with a strong command of English and the ability to work effectively with global stakeholders.

KEY RESPONSIBILITIES

1. Claims Processing and Adjudication:

- Efficiently process and adjudicate India-specific and global benefits claims, ensuring accuracy and compliance with policies

- Validate claims documentation, including gym reimbursement claims, vaccination claims, wellbeing benefits claims, school reimbursement claims, salary advance claims, etc. for global regions

- Identify discrepancies in claims and ensure timely resolutions in line with company guidelines

- Experience in similar claim processing is a must

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 and 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 and Process Improvement:

- 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 AND SKILLSET

Education:

- Graduate with specialization in Human Resources

Experience:

- 5-6 years of experience in India / Global claims processing and adjudication

- Strong understanding of various types of claims, advances, reimbursements and benefits eligible for claims

- Expertise in verifying and validating claim-related documents

- 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:

- Proficiency in Italian Language (written and verbal)

- Claims Processing experience including gym reimbursement claims, vaccination claims, wellbeing benefits claims, school reimbursement claims, salary advance claims, etc. for global regions

- Knowledge of Darwin and Workday tool - is an advantage

- Knowledge of ticket management tools like SNOW (ServiceNow) is a plus

- Documentation Validation

- Global Stakeholder Management

- Process Improvement and Compliance

- SLA and KPI Adherence

- Excellent Communication and Analytical Skills

- Exceptional command of English, with ability to communicate fluently and professionally

- Attention to detail

WORKING CONDITIONS

- Work Shift will be dependent on geography / region coverage requirements across a 24-hour by 7 service delivery

- Work From Office (No work from home)

- Agile to extended work hours when needed to meet deadlines without prompting

WHAT WE OFFER

- Competitive salary up to 9 LPA (Band BPO 3)

- Opportunity to work on global claims processes across India, Europe, SE Asia, and Middle East

- Exposure to Darwin, Workday, and ServiceNow tools

- Career growth and learning opportunities in HRO Benefits domain

- Dynamic, collaborative, and performance-driven work environment

- Comprehensive benefits as per company policy