CLAIMS ADMIN ASSOCIATE I

REPORTING RELATIONSHIP

POSITION REPORTS TO: ASSISTANT MANAGER

DEPARTMENT: OPERATION

POSITION LOCATION: VADODARA, INDIA

COMPANY: ARCHER TRANSNATIONAL SYSTEMS PVT LTD

POSITION SUMMARY

The Claims Admin Associate Operations is responsible for reviewing, managing and processing documents to support efficient and accurate Claims administration. This role involves reviewing incoming documentation from clients, applying proper naming conventions, and taking timely action in RAGIC. It includes handling Claims forms, Releases, Allocation forms, EFs, and questionnaires. The associate also manages Release or Claims packet creation, Defence review, deficiency curing, and creation of pay group reports.

JOB RESPONSIBILITIES

The candidate should be responsible for handling and reviewing claimant and reviewing medical records. Review documents received from claimants, name them correctly, and take necessary actions in the system (RAGIC).

Manage key documents such as Claims form, Release, questionnaires, and medical records to support the overall Claims Admin process. Manage deficiencies and resolve it in efficient way to reduce overall process resolution time.

Collaborate with cross-functional teams such as Pre-settlement team, Probate and Lien Ops, to ensure smooth

workflow and process.

Responsible for timely and accurate updating of MIS reports to ensure data consistency, support decision-

making, and track key operational metrics.

Create and update standard procedures (SOPs) and training materials.

Support process improvements and lead training sessions for both On-the-Job Training (OJT) and Business-as- Usual (BAU) activities to ensure smooth knowledge transfer and operational continuity.

KNOWLEDGE AND SKILLS

Bachelor's degree in any stream (preferably- commerce background).

2-5 years of work experience in reviewing documents and working in KPO/ legal field.

Understanding of Healthcare or Insurance Industry (Preferred).

Technical Skills:

Basic to Intermediate knowledge in MS Office and web-based platforms.

The candidate should be an analytics-driven individual with good critical thinking skills.

Good oral & written communications skills with active listening.

Able to work with little supervision.

The candidate typing speed should be 45+ WPM with strong command of spelling, grammar, and diction.

Knowledge of data privacy regulations (e.g., HIPAA, PHI).

Generally, support the day-to-day tasks as directed by Team Lead.

Behavioral Skills:

Basic understanding of US culture.

Ability to manage confidential information with discretion.

Maintains a respectful, responsible, and ethical approach in the workplace.

Focused on identifying and implementing process enhancements for better outcomes.

Open to new ideas, feedback, and continuous improvement while collaborating with cross-functional teams and

processes.