Claims Analyst

IndiaRemoteFull-timemid

OtherAnalyst

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Quick Summary

Overview

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Analyst based in India.

Technical Tools

OtherAnalyst

This fully remote role offers the opportunity to manage and analyze insurance and home warranty claims from end to end.
You will review claim submissions, supporting documentation, eligibility, and coverage against applicable contract terms.
The position combines analytical decision-making with customer communication, documentation, and escalation management.
You will work closely with internal teams to resolve complex claims and ensure accurate, timely outcomes.
The role requires strong attention to detail while managing a high volume of claims and maintaining productivity targets.
You will also contribute to accurate reporting, documentation, and adherence to established claims procedures.
This position follows U.S. Eastern Time business hours and includes a night shift allowance in line with applicable policy.

Manage the full claim compensation process, including reviewing submissions, documentation, denials, exceptions, and coverage eligibility.
Analyze claims and supporting evidence to determine whether requests meet applicable policy or contract requirements.
Interpret coverage provisions and authorize claim payouts within the assigned authority limits.
Identify missing or inaccurate information, flag deficiencies, and ensure customers receive timely updates regarding coverage decisions.
Handle escalated claims professionally, applying established escalation protocols and resolving issues efficiently.
Prepare clear claimant communications, including deficiency and rejection notifications.
Communicate claim updates, information requests, recommendations, and outcomes to relevant internal teams.
Escalate claim-quality concerns and complex outcomes to supervisors or appropriate specialist teams.
Maintain accurate and comprehensive claim notes documenting every action and customer interaction.
Review, track, and follow up on required documentation and additional information.
Monitor daily claims intake and proactively flag potential backlogs or processing delays.
Maintain required system log time and productivity levels, including daily claim contacts/status changes and minimum processing targets.
Follow assigned work schedules, operational procedures, policies, and quality standards.

Requirements

~1 min read

Bachelor’s degree or equivalent experience; coursework or a degree in business, insurance, or a related discipline is an advantage.
Previous experience in claims, insurance, customer service, home warranty, property insurance, or a closely related field.
Experience working with U.S.-based business teams and familiarity with U.S. business hours.
Strong understanding of reviewing documentation and assessing coverage against contractual or policy terms.
Sound judgment and analytical skills, with the ability to make accurate decisions based on available evidence.
Strong written and verbal English communication skills, particularly the ability to explain coverage decisions clearly and professionally.
Experience using claims management systems and general computer applications.
Ability to manage a high volume of open claims while maintaining accuracy, organization, and attention to detail.
Strong time-management skills and the ability to meet defined daily and weekly productivity targets.
Ability to handle escalations calmly and communicate effectively with customers and internal stakeholders.
Comfortable working independently in a remote environment while following established processes and procedures.
Availability to work the full U.S. Eastern Time business-hours overlap of approximately 7:30 PM–3:30 AM IST.
Ability to maintain a quiet remote workspace with an internet connection of at least 30 Mbps download / 10 Mbps upload.