Claims Adjudication Specialist

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 gym reimbursement claims, vaccination claims, wellbeing benefits claims, school reimbursement claims, Salary advance claims etc. for global regions
Identify discrepancies in claims and ensure timely resolutions in line with company guidelines
Experience in similar claim processing is a must
Knowledge and working experience of Darwin and Workday is a plus
Knowledge of ticket management tools like SNOW is a Plus.
Stakeholder Engagement:
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.
SLA & KPI 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.
Policy Adherence & Process Improvement:
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.
Qualification & Skillset:
Graduate and specialization in Human resources
5–6 years of experience in India / Global claims processing and adjudication.
Strong understanding of various types of claims, advances , reimbursements and benefits eligible for claims
Expertise in verifying and validating claim-related documents.
Exceptional command of English, with the ability to communicate fluently and professionally.
Attention to detail
Proven experience collaborating with global stakeholders across regions.
Deep understanding of SLAs and KPIs and a track record of achieving or exceeding them.
Key Skills:
Proficiency in Italian Language (written and verbal)
Claims Processing experience including gym reimbursement claims, vaccination claims, wellbeing benefits claims, school reimbursement claims, Salary advance claims etc. for global regions
Knowledge of Darwin and Workday tool – is an advantage
Documentation Validation
Global Stakeholder Management
Process Improvement and Compliance
SLA & KPI Adherence
Excellent Communication and Analytical Skills
Working Conditions:
Work Shift will be dependent on geography/region coverage requirements across a 24-hour * 7 service delivery
Work from Office (No work from home)
Agile to extended work hours when needed to meet deadlines without prompting.

Work arrangement
No