489 Claims Processing jobs in India

About the Role

This role provides an excellent opportunity to be a part of Swiss Re L&H Claims team and collaborate with clients and various teams within Swiss Re locally and regionally. This role will be instrumental in the implementation of a significant and relevant claims' philosophy whilst promoting and sharing standard process claims management techniques with clients and internal stakeholders. In this role, you will:

About You

Education and professional experience:

Skills requirements:

Behavior requirements:

About the Team

Swiss Re Life and Health (L&H) Re Claims forms part of the Swiss Re L&H Reinsurance. In addition to the Claims management of existing business, the team ensures insights gained from in-force business are appropriately incorporated in our new business activities.

L&H Re-claims team works closely with many Swiss Re teams specifically L&H UW, pricing, and Client Markets to ensure Swiss Re has aligned priorities and customer focus whilst delivering market-specific, portfolio-directed services, which support our overall strategic approach to handling risks and client relationships.

We are looking for team members who stand for integrity, improve continually, and navigate ambiguity. This means having the courage to be curious and to stretch yourself beyond what you already know. We want team members who inspire change fearlessly and don't always opt for the easy option, and can stay calm, focused, and resilient during difficult times.

Regardless of what position we have at Swiss Re, all of us can be courageous, which will also help us in our personal and professional growth.

Swiss Re offers modern hybrid working arrangements that allow all employees to adapt to changing work preferences. We currently provide employees with attractive offices, competitive benefits including annual leave, work anniversary leave and insurance coverage for medical, personal accident and life.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, colour, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

We look forward to your application!

• Review and analyze insurance claims documentation to determine coverage and liability.
• Investigate claims by gathering information from claimants, policyholders, witnesses, and other relevant sources.
• Evaluate the validity and extent of damages or losses reported.
• Negotiate settlements with claimants and their representatives in a fair and timely manner.
• Process claims payments and manage reserve requirements accurately.
• Ensure compliance with all relevant insurance laws, regulations, and company policies.
• Maintain clear and concise claim files, documenting all activities and decisions.
• Identify potential cases of fraud and escalate them for further investigation.
• Provide clear explanations of policy coverage and claim decisions to policyholders.
• Collaborate with legal counsel and other departments as needed to resolve complex claims.

• Analyze complex insurance claims data to identify trends, patterns, and root causes.
• Develop and maintain reports and dashboards to track key performance indicators (KPIs).
• Conduct statistical analysis and provide actionable insights for claims process improvement.
• Collaborate with claims teams to understand operational challenges and data needs.
• Ensure data accuracy, integrity, and consistency in claims databases.
• Assist in the development and implementation of new analytical models and methodologies.
• Monitor regulatory changes and their impact on claims data analysis.
• Present findings and recommendations to management and other stakeholders.
• Identify opportunities for automation in claims data processing and analysis.
• Stay updated with the latest advancements in data analytics and insurance trends.

• Proven experience as a Data Analyst, Claims Analyst, or similar role.
• Strong analytical, statistical, and problem-solving skills.
• Proficiency in SQL for data querying and manipulation.
• Experience with data visualization tools (e.g., Tableau, Power BI).
• Familiarity with statistical software packages (e.g., R, Python libraries).
• Excellent understanding of insurance claims processes and terminology.
• Ability to interpret complex data and communicate findings clearly.
• Bachelor's degree in Statistics, Mathematics, Economics, or a related field.
• At least 5 years of experience in data analysis, with a preference for the insurance sector.

• Review, analyze, and process insurance claims in accordance with policy terms and conditions.
• Investigate claims to determine coverage, liability, and compensation amounts.
• Communicate with policyholders, claimants, and third parties to gather information and explain claim status.
• Identify and investigate potentially fraudulent claims.
• Negotiate settlements with claimants and legal representatives when necessary.
• Ensure accurate and timely data entry and record-keeping of all claim-related activities.
• Maintain up-to-date knowledge of insurance laws, regulations, and industry trends.
• Provide guidance and support to junior claims adjusters and processors.
• Prepare reports on claim trends, performance metrics, and reserve requirements.
• Contribute to the continuous improvement of claims handling procedures and systems.
• Collaborate with underwriting and legal departments to resolve complex claims issues.
• Uphold the company's commitment to customer service and fair claims handling.

• Bachelor's degree in Business Administration, Finance, or a related field.
• Minimum of 4 years of experience in insurance claims processing, with a focus on property and casualty or health insurance.
• In-depth knowledge of insurance policies, claims procedures, and relevant legal frameworks.
• Strong analytical and critical thinking skills.
• Excellent written and verbal communication abilities.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to manage a caseload efficiently and meet deadlines.
• High level of integrity and ethical conduct.
• Demonstrated ability to work autonomously and effectively in a remote setting.
• Relevant insurance certifications (e.g., CPCU, AIC) are highly desirable.

• Investigate, evaluate, and process insurance claims accurately.
• Interpret insurance policies and determine coverage.
• Communicate claim status and decisions to policyholders and stakeholders.
• Gather and review claim documentation and evidence.
• Negotiate settlements within policy limits and authority.
• Identify and report suspicious or fraudulent claims.
• Ensure compliance with all applicable regulations and company procedures.
• Maintain organized and detailed claim files.

• Bachelor's degree in Business, Finance, or a related field.
• 4+ years of experience in insurance claims processing or analysis.
• Strong knowledge of insurance policies and procedures.
• Proficiency in claims management software.
• Excellent analytical and problem-solving skills.
• Superior written and verbal communication abilities.
• Ability to work independently in a remote environment.