Claims Specialist

About Tata Consultancy Services

Tata Consultancy Services (TCS) is a global digital transformation and technology services partner serving leading organizations across industries. Established in 1968 and built on the Tata Group legacy, the company emphasizes innovation, strong engineering practices, and high service standards. TCS operates with a large global workforce across 55 countries and 180 delivery centers, and it has been recognized as a leading employer worldwide. The organization focuses on building long-term client relationships by helping businesses adapt through multiple technology cycles, from legacy systems to modern artificial intelligence solutions. TCS also supports major marathon and endurance events around the world to encourage health, sustainability, and community engagement. The company reported consolidated revenues of US $30 billion for the fiscal year ending March 31, 2025.

Role Overview

This is a full-time permanent remote position for a Claims Specialist with experience in FineOS and disability-related claims handling. The role centers on absence case management, claim review, benefit determination, and communication with claimants and clients.

Key Responsibilities

The selected candidate will manage absence cases and adjudicate claims using medical evidence and the rules tied to disability, FMLA, and paid family leave programs. The work includes reviewing eligibility, evaluating claim types such as intermittent or continuous leave, and deciding whether claims should be approved or denied based on carrier and employer guidelines.

The role also involves examining medical records and supporting documents such as physician reports, diagnostic test results, office notes, and operative reports to assess whether the claimant meets the definition of disability. The specialist will identify incomplete files, request missing information from employees, physicians, or employers, and keep cases moving toward resolution.

Additional duties include calculating benefits, processing payments, making adjustments for workers’ compensation, state short-term disability, and other offsets, and ensuring claims are handled accurately and on time. The position requires regular communication with claimants and clients, review of critical client deliverables, workload management, escalation handling, and support for peer review and process accuracy. The specialist may also contribute improvement ideas and support special projects when assigned.

Requirements

Applicants should have at least 1 year of experience in disability, FMLA, PFL, or other insurance claims work. Practical experience with FINEOS is required. A solid understanding of medical terminology and claim-supporting documents is needed, along with familiarity with disability insurance claims, benefits administration, offsets, deductions, disability duration, and medical management practices.

Strong verbal and written communication skills are essential, including the ability to present information clearly. The role also calls for analytical thinking, sound decision-making, problem-solving ability, and people-management skills. Candidates should be comfortable using computers and common business software such as MS Office, including Excel, Word, and PowerPoint. A willingness to adapt quickly in a fast-paced environment and a desire to keep learning are important. The ability to identify escalated cases and work with a team leader on corrective action is also expected.

Additional Information

Work location: Remote. Employment type: Full Time / Permanent.