Tech Minds Agency
B2B • eCommerce • Education
Tech Minds Agency is a creative IT solutions provider that specializes in helping businesses and individuals leverage technology for growth and success. They offer a diverse range of services including website creation, mobile app development, digital marketing, and training in various technical skills. Their mission is to navigate the evolving tech landscape, enabling clients to enhance their online presence and achieve their business goals. With a focus on personalized service and staying ahead of tech trends, Tech Minds Agency aims to empower its clients through innovative solutions and expert support.
Business Analyst – Claims Management, Insurance
Job not on LinkedIn
3 days ago
Tech Minds Agency
B2B • eCommerce • Education
Tech Minds Agency is a creative IT solutions provider that specializes in helping businesses and individuals leverage technology for growth and success. They offer a diverse range of services including website creation, mobile app development, digital marketing, and training in various technical skills. Their mission is to navigate the evolving tech landscape, enabling clients to enhance their online presence and achieve their business goals. With a focus on personalized service and staying ahead of tech trends, Tech Minds Agency aims to empower its clients through innovative solutions and expert support.
📋 Description
• Owns design and documentation of claims processing workflows, including automation, workload management, and TPA integration, ensuring compliance with IRDAI and SLA standards. • Map end-to-end claims process: intimation ? adjudication ? approval ? payment. • Define workload balancing logic and queue management rules for claims teams. • Design data and process interfaces with TPAs (EDI/API structures). • Define claim status taxonomy, turnaround times, and escalation hierarchies. • Support configuration of fraud triggers and quality checks. • Ensure regulatory compliance for cashless and reimbursement claim processing.
🎯 Requirements
• 4-5 years in health claims operations (retail/group), with process re-engineering experience. • Experience working with TPAs and API data exchanges in India. • Familiar with claims systems (e.g., MediAssist, Raksha, Core IT platforms). • Strong analytical and problem-solving skills for system testing and exception handling. • Proven ability to translate business process logic into system requirements. • Skilled in as-is and to-be mapping, gap analysis, and workflow design. • Experience working with IT development and QA teams on core insurance systems. • Deep understanding of IRDAI regulations, esp. regarding claims management and customer grievance reporting. • Excellent documentation, analytical, and stakeholder management skills.
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