Claims Reviewer

Principal Global Services; Pune District; Hybrid; INR 400,000 - 640,000; Full time

Job summary

Principal Global Services in Pune, India is seeking a detail-oriented Claims Reviewer to analyze health, life, and disability claims, determine required actions, and support process improvements. You will consult documentation and colleagues to complete daily tasks and ensure timely processing while contributing to client satisfaction and profitability.

Training lasts about 3–3.5 months with 5 days/week in the office, then a hybrid work model.

Qualifications

• Bachelor's degree in life sciences or equivalent required.
• 2-3 years’ back-office experience preferred.
• Experience in health insurance claims processing or underwriting helpful.
• Strong MS Office and communication skills.

Responsibilities

• Analyze details to determine actions for processing transactions.
• Consult resources and colleagues to perform daily tasks.
• Suggest improvements in procedures and processes.
• Meet or exceed production goals with efficient processing.
• Maintain high quality and client satisfaction through accurate work.

Skills

MS Office

Written & verbal communication

Education

Bachelor's degree in life sciences or equivalent

Tools

MS Office

Job description

What You'll Do

Responsibilities

As a Claims Reviewer, you will:

• Analyze details to determine appropriate actions needed for processing transactions.
• Consult available resources including technical documentation, updates, computer system application features, co-workers, and mentors to perform daily tasks.
• Make suggestions for improvements in procedures/processes.
• Process work efficiently and effectively to meet or surpass production goals.
• Perform assigned tasks precisely to fulfill or surpass quality expectations, leading to enhanced client happiness and profitability for PFG.
• Improve personal efficiency to positively impact work, environment, and improvement of skills.
• Perform other job-related duties, processes within the BU, or special projects as assigned by outstanding supervisors. Prioritize workload to ensure financial, urgent, and rush requests are processed on time.
• Take ownership of individual production results to consistently achieve high results, contributing to department efficiency.
• Assist Trainer/Leader in analyzing error trends and conducting root cause analysis of defects.

Shift Flexibility:
The role requires flexibility to work in rotational shifts, with shift schedules typically changing every quarter.

Shift Timings:

• Morning Shift: 6:00 AM to 3:00 PM IST (fixed timing)
• Night Shift: 5:30 PM to 2:30 AM IST or 6:30 PM to 3:30 AM IST

Training Period:

• Employees are required to work from the office 5 days a week during the training period.
• 1 month of classroom training.
• 2 months of ramp-up and on-the-job learning.

Post-Training Work Model:

• Upon successful completion of the training period (approximately 3 to 3.5 months), employees will transition to a hybrid work model.

Who You Are

Qualifications

To succeed in this role, you should have:

• A Bachelor's degree in life sciences or equivalent experience preferred.
• Minimum of 2-3 years’ experience in back office.
• Experience in Claims processing of Health Insurance, Life and disability claims, or Underwriting.
• Good MS Office skills.
• Good written and verbal communication skills.

If you are an ambitious individual with a proven background in finance or insurance and a passion for delivering world-class results, we want you on our team!

Why choose Principal Financial Group?

We are committed to encouraging an inclusive and collaborative work environment where your expertise is valued. At Principal Financial Group, you will have the opportunity to grow your career, work with dedicated professionals, and contribute to the seamless delivery of our operations. Join us to be a part of a company that competes at the highest level and is determined to succeed!