Claims Specialist

Case Worker
Location: Noida (Work From Office)
Shift: US Shift

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Role Overview

The Case Worker is an individual contributor responsible for managing SSD and SSA case files end to end, from intake to final determination. The CW works as part of a team reporting to the Case Manager, and is expected to process assigned cases accurately, on time, and in compliance with process standards. This role is central to the team's capacity to process 200+ cases while maintaining accuracy, compliance, and client satisfaction.

Key Responsibilities

Case Flow Management

• Understand and manage end-to-end SSD case flow for assigned cases, from initial intake to final determination.
• Complete case-related tasks accurately and within defined timelines.
• Identify when a case requires escalation and route it to the Case Manager promptly.
• Keep the assigned case pipeline updated so no case falls through the cracks.

Team Contribution

• Work as part of a team of Case Workers, coordinating with peers on shared case queues and handoffs.
• Participate in regular check-ins and coaching sessions with the Case Manager to address bottlenecks and improve throughput.
• Flag blockers, delays, or recurring issues to the Case Manager as they come up, rather than after the fact.

Reporting & Documentation

• Maintain accurate records of own case activity, escalation logs, and outcome data.
• Update case status in the tracking system as required, so productivity and pipeline health can be measured.
• Report any task manipulation or avoidable delays on assigned cases to the Case Manager.

AI Tools & Automation

• Use AI-powered tools, including real-time case support assistants, to process cases more efficiently.
• Contribute case conversations toward building and refining the team's AI knowledge base to improve response accuracy.
• Use automation integrations (benefits tools, chronicles integration) to reduce manual effort on case filing.
• Stay current with evolving AI tools and workflows, and adopt new tools as they're rolled out.

Critical Thinking & Problem Solving

• Assess case patterns and process gaps within their own caseload and flag them to the Case Manager.
• Exercise sound judgment in identifying edge cases versus standard flow, knowing when to act versus escalate.
• Proactively flag risks to case timelines or compliance before they become escalations.

Required Qualifications

• 3+ Years of Experience in case management, case processing, or a similar process-driven role.
• Ability to work as part of a team in a fast-paced, process-driven environment.
• Basic understanding of reporting frameworks and productivity metrics.
• Critical thinking and analytical skills, able to assess situations and make sound decisions.
• Familiarity with AI tools and digital workflows, comfort learning and adopting new technologies.
• Good written and verbal communication skills for documentation and coordination with the team.

Preferred / Add-On Qualifications

• Working knowledge of SSA and SSD application processes.
• Prior experience with case management software or CRM platforms (e.g., chronicles or equivalent).
• Exposure to process automation or workflow improvement initiatives.
• Familiarity with AI-assisted productivity tools or real-time support systems.