Company:MercerDescription:
INTERNAL JOB POSTING
We are seeking a talented individual to join our Insurance Operations team at Mercer. This role will be based in Pune. This is a hybrid role that has a requirement of working at least three days a week in the office.
Specialist – Insurance Operations (Grade C1)
No. of Open roles - 1
Last Date to Apply: 15th January, 2025
What can you expect?
We are looking to hire a Specialist in the Healthcare eligibility checks, running various reports and confirming the reports logic with the client requirements, claims adjudication and email enquiries team.
The role will be responsible for uploading the data set received from clients that may/ may not requires data changes/ updates, validating the proration calculations done by the Mercer tools or at times completely manual calculations, data validation/ reconciliation from various excel files, running various data logics to verify the plan rules & eligibility check of the employee basis the agreed eligibility rules with client. This role also demands to validate the output generated through various reports and the report rules and logic agreed with the client. The role also demands to resolve email enquiries of the employees related to settlement disputes, claims status, estimation of benefits coverage, product coverage etc.
The role also may be responsible for validating the claims adjudication of medical claims for the employees of our clients based in Singapore and other Asia countries in addition to the above requirements.
What is in it for you?
- Holidays (as per location)
- Shared Transport (Provided the address falls in service zone)
- Medical insurance, personal accident insurance, group term life insurance from the day you join us
We will count on you to:
- Assist in the processing and administration of processes related to health insurance operations
- Email enquiries handling for health insurance products
- Manage huge data sets and validation/ reconciliation of data from multiple data files to get the desired output
- Able to verify the tool input/ output for proration and eligibility checks as per client plan rules
- Updating all documentation (e.g. SOP, client exception tracker etc.) and training of team members
- Drive the culture of First Time Right
- Preparation of Month end/Weekly/Daily Reports
- Support self-development (cross trainings, process training, soft skill trainings etc)
- Support all projects and quality initiatives – Process improvement ideas.
What you need to have:
- Graduation / post-graduation in any stream
- 3+ years of experience in healthcare domain including billing.
- Excellent attention to detail and organizational skills.
- Ability to work effectively in a team environment.
- Proficiency in MS Office applications.
- Excellent written & verbal communication skills
- Experience in email query handling.
- Should be good/ proficient in MS Excel to perform basic and medium complex calculations related to prorated benefits for new hires, terminations, claims payout, refunds, and deductions. Should be able to manage data sets and comparing these with multiple excel files to get the correct output per the client’s requirements
- Significant experience purely in healthcare claims and eligibility rules management - verification of bills under various health products, eligibility rules as per the client requirements
- Experience in SOPs updating.
Eligibility:
- Minimum 3 years’ experience in service industry
- Minimum 12 months experience as Senior Analyst/ Specialist
- Should have at least “Meets Expectations” or equivalent rating in last appraisal
- Should not be under any Performance Continuity Plan, or had any official Disciplinary action within the last 3 months
- Should not have applied for any other IJP within Mercer in the last 3 months
What makes you stand out?
- Well-developed Healthcare skills and the demonstrated ability to work in a globally matrixed and significantly multi-geography, multi-cultural offshore service delivery environment.
- Excellent Communication Skills both written & verbal.
- Executive presence that conveys composure and confidence in all situations
- Strong analytical, research and problem-solving skills, attention to details
Why join our team?
- We help you be your best through professional development opportunities, interesting work and supportive leaders.
- We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients and communities.
- Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.
Disclaimer
- Please note that the relocation assistance shall not be provided for the said position
- Candidates who wish to apply for inter-location positions are required to check with the Transport Help Desk (THD) to confirm if their place of residence is within the served transport service zone
- Mention your employee id and official email address in the resume
Mercer believes in building brighter futures by redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. Mercer’s more than 20,000 employees are based in 43 countries and the firm operates in over 130 countries. Mercer is a business of Marsh McLennan (NYSE: MMC), the world’s leading professional services firm in the areas of risk, strategy and people, with more than 85,000 colleagues and annual revenue of over $23 billion. Through its market-leading businesses including Marsh, Guy Carpenter and Oliver Wyman, Marsh McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit mercer.com. Follow Mercer on LinkedIn and X.
Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, caste, disability, ethnic origin, family duties, gender orientation or expression, gender reassignment, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law.
Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person.
Mercer, a business of Marsh McLennan (NYSE: MMC), is a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $23 billion and more than 85,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit mercer.com, or follow on LinkedIn and X.Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, caste, disability, ethnic origin, family duties, gender orientation or expression, gender reassignment, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law.Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person.
