The HR Executive – Employee Services & Operations is responsible for managing employee benefits programs, handling HR operations, and ensuring seamless employee services. This role involves coordinating with internal teams, external vendors, and government authorities to ensure compliance, efficiency, and high-quality service delivery.
Key Performance Areas (KPAs) & Principal Accountabilities:
1 Employee Services & Benefits Administration:
• Manage and administer employee benefits programs, including medical insurance and other employee services such as certificates, letter issuance, and reimbursements processing.
• Develop and maintain relationships with external vendors and service providers to ensure accurate and efficient administration of benefits programs.
• Provide excellent customer service by addressing employee inquiries, resolving issues, and ensuring benefits programs are effectively managed.
• Process benefit enrollments, changes, and terminations promptly and accurately.
• Maintain accurate and up-to-date employee benefits data in the HR Information System (HRMS).
2 Employee Life-Cycle Management & HR Operations:
• Ensure accurate record creation in HRMS for new role creations and separations.
• Assist onboarding and payroll teams in completing HRMS documentation for new hires and coordinate timely completion of probation confirmation, including issuing confirmation letters.
• Support offboarding processes by coordinating exit clearance procedures and managing separation documentation.
• Act as a custodian for all employee-related letters and associated documentation.
• Coordinate with the PRO team and line managers for employee-related documentation and approvals related to visa renewals and cancellation.
3 Claims Management & Medical Insurance:
• Review, verify, and process medical insurance claims submitted by employees and healthcare providers.
• Ensure claims comply with insurance policy guidelines and regulatory standards.
• Follow up on pending or denied claims and work with insurers to resolve issues.
4 Documentation & Record Keeping:
• Maintain accurate and detailed records of claims, approvals, denials, and payments.
• Collect and verify required documentation, such as medical reports, invoices, and authorization forms.
5 Communication & Coordination:
• Act as a liaison between employees, healthcare providers, and insurance companies.
• Respond to inquiries related to claims, policies, and reimbursement timelines.
• Escalate unresolved issues to the appropriate authority.
6 Reporting & Compliance:
• Prepare periodic reports on claim statuses, trends, and performance metrics.
• Identify areas for process improvement and recommend solutions.
• Ensure adherence to all legal, regulatory, and organizational policies related to insurance claims.
• Stay updated on changes in medical insurance policies and procedure.
Requirements
Qualitative Requirements:
Experience (Yrs & Field) : 2-4 years of experience in HR operations, employee benefits, or medical insurance claims management. Strong familiarity with HRMS, insurance policies, claims processes, and healthcare terminology.
Educational Qualification Bachelor’s degree in human resources, Business Administration, or a related field.
Certifications Certification in Medical Billing or Insurance Processing (preferred).
Skills & Abilities Skills:
• Strong organizational and multitasking abilities.
• Proficient in claims processing software and MS Office applications.
• Excellent communication and interpersonal skills.
• Analytical mindset with attention to detail.
Key Competencies:
• Problem-solving and decision-making skills.
• Customer service orientation.
• Ability to work under pressure and meet deadlines.
• Ethical handling of sensitive patient and insurance data.
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