476 Claims Processor jobs in India

I'm sharing you the detailed Job description of Business Process Delivery - Claims Management Processor at Accenture.

Qualification – B.COM Graduates only

Mode of Work(WFH or WFO) - WFO

Interview process – 2 Rounds of interview

Location – Mumbai

Shift Timing –  5.30pm to 3am 

Deliver end to end insurance claims processing services. Develop and deliver business solutions to improve insurance claims process.

• Investigate insurance claims by gathering information from policyholders, witnesses, and other relevant sources.
• Analyze policy coverage and assess damages or losses incurred.
• Determine the extent of the company's liability and negotiate settlements with claimants.
• Prepare detailed reports documenting claim investigations, findings, and recommendations.
• Maintain accurate and organized claim files using company software systems.
• Ensure compliance with all relevant insurance regulations and company procedures.
• Provide clear and timely communication to policyholders throughout the claims process.
• Collaborate with legal counsel, repair facilities, and other service providers as needed.
• Identify potential fraud and follow established protocols for investigation.
• Continuously update knowledge of insurance products and claims handling best practices.
  

• Bachelor's degree in Business, Finance, or a related field, or equivalent work experience.
• Minimum of 3 years of experience in insurance claims adjustment.
• Strong understanding of insurance policies, claims investigation, and negotiation techniques.
• Excellent analytical and critical thinking skills.
• Exceptional interpersonal and communication abilities, both written and verbal.
• Proficiency in claims management software and standard office applications.
• Ability to work independently and manage multiple claims simultaneously.
• Strong negotiation and conflict-resolution skills.
• Customer-focused approach with a commitment to service excellence.
• Valid driver's license and willingness to travel to claim sites as required.

• Investigate insurance claims to determine coverage and liability.
• Interview claimants, witnesses, and relevant parties to gather information.
• Inspect damaged property and assess the extent of losses.
• Review policy documents and claim forms for accuracy and completeness.
• Negotiate settlements with claimants and their representatives.
• Prepare detailed reports on claim investigations and findings.
• Ensure compliance with insurance laws and regulations.
• Process payments and manage claim files efficiently.
• Provide excellent customer service to policyholders throughout the claims process.

• High school diploma or equivalent; Bachelor's degree preferred.
• Minimum of 2-4 years of experience as an insurance claims adjuster or in a related field.
• Knowledge of insurance policies, claims processing, and investigation techniques.
• Strong analytical and problem-solving skills.
• Excellent communication, negotiation, and customer service skills.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to work independently and manage a caseload effectively.
• Relevant insurance licenses or certifications are a plus.

• Investigate insurance claims promptly and thoroughly by gathering information, interviewing claimants and witnesses, and reviewing policy coverage.
• Assess the damage or loss reported and determine the extent of the company's liability based on policy terms and conditions.
• Negotiate settlements with policyholders and their representatives in a fair and efficient manner.
• Prepare detailed reports on claim investigations, findings, and recommendations.
• Maintain accurate and organized claim files, ensuring all documentation is complete.
• Liaise with legal counsel, repair shops, medical providers, and other third parties as needed.
• Adhere to all relevant insurance laws, regulations, and company policies.
• Manage a portfolio of claims, prioritizing tasks and ensuring timely resolution.
• Provide excellent customer service to policyholders throughout the claims process.
• Identify potential cases of fraud and escalate them for further investigation.
• Stay updated on industry best practices and changes in insurance legislation.
• Conduct on-site assessments of property damage or injury where necessary.
• Attend court hearings or depositions when required.

• Bachelor's degree in Finance, Business Administration, or a related field.
• Proven experience as a Claims Adjuster or in a similar role within the insurance industry.
• Strong understanding of insurance policies, claims processing, and legal/regulatory requirements.
• Excellent investigative, analytical, and problem-solving skills.
• Exceptional negotiation and communication abilities (both written and verbal).
• Proficiency in using claims management software and standard office applications.
• Ability to manage a caseload effectively and meet deadlines.
• High level of integrity and attention to detail.
• Customer-focused approach with a commitment to providing outstanding service.
• Valid Adjuster's license or willingness to obtain one is required.