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    • Minimum 3 years of experience in US Healthcare employee benefit claims.
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Senior Analyst - Claim Operations
Gallagher
·
3.1
Pune, Maharashtra
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Job details

Pay information not provided
Pune, Maharashtra

Full job description

Introduction
Welcome to Gallagher in India — where expertise, technology, and purpose come together. Since 2006, Gallagher in India has supported global teams by delivering quality, service, and speed through deep expertise, smart technology, and specialized knowledge services. More than just an operations center, it’s a place where careers grow through collaboration, continuous learning, and purposeful work. We drive efficiency, compliance, and innovation so our teams can focus on serving clients. If you enjoy solving problems and working with purpose, Gallagher is the place where you can grow and feel a sense of belonging.

Overview
  • Minimum 3 years of experience in US Healthcare employee benefit claims
  • Proven track record of successful claim resolutions and customer satisfaction.
  • Strong knowledge of US Healthcare insurance regulations, policies, and procedures.
  • Hands on experience in approving EB claims like Dental, physiotherapy and other procedures
  • Confirm patient insurance coverage, deductibles, and eligibility against policy guidelines.
  • Calculate the correct reimbursement amount to issue payments or formally deny/pend invalid claims.
  • Perform Employee benefit determination and pay/deny decisioning per plan rules
  • Communicate with healthcare providers, patients, and internal departments to resolve discrepancies.
  • Follow federal/state regulations and guidelines to protect sensitive patient information (HIPAA). Mitigate organizational risk, maintaining compliance and reputation


How you'll make an impact
    • Hands on experience in approving EB claims like Dental, physiotherapy and other procedures
    • Confirm patient insurance coverage, deductibles, and eligibility against policy guidelines.
    • Calculate the correct reimbursement amount to issue payments or formally deny/pend invalid claims.
    • Perform Employee benefit determination and pay/deny decisioning per plan rules
    • Communicate with healthcare providers, patients, and internal departments to resolve discrepancies.
    • Follow federal/state regulations and guidelines to protect sensitive patient information (HIPAA). Mitigate organizational risk, maintaining compliance and reputation


About you

Qualifications:


  • Bachelor’s degree in insurance or related field

Certificate(s)/Special Training: Insurance industry certifications – AIC, AINS, Cert CII or any other relevant Insurance certification



Additional Information

At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.
  • Competitive compensation
  • Comprehensive benefits programs designed to support your well-being
  • Career development opportunities and ongoing learning
  • A collaborative, people-first culture with accessible leadership
  • The opportunity to do meaningful work with global reach and local impact
At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.
Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)
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