Claims Processing and Adjudication

TCS Bangalore is Hiring for Claims Processing and Adjudication (HRO Operations) Location - Bangalore Only Work from Office (No Hybrid, No Remote, No Work from Home) 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 benefits and claims adjudication with a strong focus on India-specific claims . The ideal candidate will be well-versed in various types of reimbursement claims , associated documentation requirements, and global claim processes. This role demands a meticulous professional with a strong command of English and the ability to work effectively with global stakeholders. Key Responsibilities: Claims Processing & Adjudication:

• Efficiently process and adjudicate India-specific and global benefits claims, ensuring accuracy and compliance with policies.
• Validate claims documentation, including reimbursements, medical claims, and other employee benefits claims.
• Identify discrepancies in claims and ensure timely resolutions in line with company guidelines
• Knowledge and working experience of Darwin and workday and service now is mandatory

• 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.

• 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 .

• 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.

• Graduate and specialization in Human resources
• 5–6 years of experience in global HRO benefits and claims processing , with substantial exposure to India-specific claims adjudication .
• Strong understanding of various types of benefits (e.g., Health, Medical, travel, education, and other reimbursements).
• Expertise in verifying and validating claim-related documents.
• Exceptional command of English , with the ability to communicate fluently and professionally.
• Proven experience collaborating with global stakeholders across regions.
• Deep understanding of SLAs and KPIs and a track record of achieving or exceeding them.

• Benefits & Reimbursement Claims Adjudication and Processing
• Knowledge of Darwin and Workday tool - Mandatory
• Documentation Validation
• Global Stakeholder Management
• Process Improvement and Compliance
• SLA & KPI Adherence
• Excellent Communication and Analytical Skills

• Flexible working 24*7 shift timings.

• Agile to extended work hours when needed to meet deadlines without prompting.