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Claims Adjustment Specialist @ ADP

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 Claims Adjustment Specialist

Job Description

Responsibilities:

The Claim Adjustment Specialist is responsible for end-to-end validation, reviewing and responding to all requests and questions with respect to Risk Management-related issues which include workers compensation claims. Provide direct assistance on all claim-related questions or requests. Take ownership of the question or request and ensure the question or request is properly handled or documented.


  • Coordinate with TPA on claim issues and concerns while providing claim oversight.
  • Accurately document claim activities and maintain up to date records in claim management system.
  • Review claim forms, supporting documents and customer information.
  • Validate claim eligibility based on policy coverage, limits and conditions.
  • Identify discrepancies, missing information or fraud indicators.
  • Meet TAT, accuracy and SLA targets.

Skills Required:

  • Strong Analytical skills and attention to detail
  • Attention to detail
  • Excellent Communication skills

Preferred Experience:

  • 1-2 years of experience in Claims Management or Claims processing is mandatory

Job Classification

Industry: IT Services & Consulting
Functional Area / Department: Customer Success, Service & Operations
Role Category: Operations
Role: Subject Matter Expert
Employement Type: Full time

Contact Details:

Company: ADP
Location(s): Hyderabad

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Keyskills:   Adjudication Claims Adjudication Claims Processing

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