Claims Admin Associate I
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Job Location:
Monthly Salary:
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
POSITION SUMMARY
POSITION REPORTS TO : ASSISTANT MANAGER
DEPARTMENT : OPERATION
POSITION LOCATION : VADODARA INDIA
The Claims Admin Associate – Operations is responsible for reviewing managing and processing documents to
support efficient and accurate Claims administration. This role involves reviewing incoming documentation from
clients applying proper naming conventions and taking timely action in RAGIC. It includes handling Claims forms
Releases Allocation forms EFs and questionnaires. The associate also manages Release or Claims packet creation
Defence review deficiency curing and creation of pay group reports.
JOB RESPONSIBILITIES
The candidate should be responsible for handling and reviewing claimant and reviewing medical records.
Review documents received from claimants name them correctly and take necessary actions in the system
(RAGIC).
Manage key documents such as Claims form Release questionnaires and medical records to support the
overall Claims Admin process.
Manage deficiencies and resolve it in efficient way to reduce overall process resolution time.
Collaborate with cross-functional teams such as Pre-settlement team Probate and Lien Ops to ensure smooth
workflow and process.
Responsible for timely and accurate updating of MIS reports to ensure data consistency support decision-
making and track key operational metrics.
Create and update standard procedures (SOPs) and training materials.
Support process improvements and lead training sessions for both On-the-Job Training (OJT) and Business-as-
Usual (BAU) activities to ensure smooth knowledge transfer and operational continuity.
Knowledge & Skills
Bachelor’s degree in any stream (preferably- commerce background).
2-5 years of work experience in reviewing documents and working in KPO/ legal field.
Understanding of Healthcare or Insurance Industry (Preferred).
Technical Skills:
Basic to Intermediate knowledge in MS Office and web-based platforms.
The candidate should be an analytics-driven individual with good critical thinking skills.
Good oral & written communications skills with active listening.
Able to work with little supervision.
The candidate typing speed should be 45 WPM with strong command of spelling grammar and diction.
Knowledge of data privacy regulations (e.g. HIPAA PHI).
Generally support the day-to-day tasks as directed by Team Lead.
Behavioral Skills:
Basic understanding of US culture.
Ability to manage confidential information with discretion.
Maintains a respectful responsible and ethical approach in the workplace.
Focused on identifying and implementing process enhancements for better outcomes.
Open to new ideas feedback and continuous improvement while collaborating with cross-functional teams and
processes
