Description

Course Name: Professional Diploma in Insurance Claims Processing

Global Occupational Skill Standard – GOSS ID: GOSS/PD-FBI-ICP-185

Eligibility: 10+2 or equivalent

Language Type: English

Course Type: Self-Paced Online Learning

Objective: The Professional Diploma in Insurance Claims Processing aims to enhance learners’ understanding of claim procedures, documentation, verification, assessment, and settlement processes. The course focuses on developing skills in claims handling, policy interpretation, fraud awareness, customer communication, and regulatory compliance to ensure accurate and efficient insurance claim management.

Duration: 6 Months / 370 Hours

Steps to become a GSDCI Certified Professional:

Step 1: Select your Course you want to pursue.

Step 2: Click on get Enroll Now tab, new pop up window will open.

Step 3: Click on pay Course fee, you will be redirected to billing details page.

Step 4: Fill your details and click on pay course fee, you will be redirected to payment gateway, pay fee by any available options like Card (Debit/Credit), Wallet, Paytm, Net banking, UPI and Google pay.

Step 5: You will get Login Credentials of Online E-Books and Online assessment link on your email id, within 48 hrs of payment.

Step 6: After completion of the online assessment, the Digital(PDF) copy of your Diploma & Marksheet will be sent to your registered email ID within 7 days.

Course Modules:

Module 1: Fundamentals of Insurance Claims Processing: Introduction to Insurance Claims Processing, History and Evolution of Insurance Claims Management, Types of Insurance Policies and Claims, Insurance Terminology and Concepts, Insurance Claims Life Cycle, Role and Responsibilities of Claims Processors, Claim Registration and First Notice of Loss (FNOL), Policy Verification and Coverage Assessment, Claims Documentation Requirements, Ethics and Professional Practices in Claims Handling.

Module 2: Insurance Claim Investigation and Evaluation: Introduction to Claim Investigation, Claim Information Gathering Techniques, Policyholder Statement Analysis, Evidence Collection and Verification, Fraud Detection and Prevention Methods, Claim Adjusting Procedures, Loss Assessment and Evaluation, Medical and Property Claim Investigation, Liability Assessment Process, Claim Investigation Reporting.

Module 3: Health Insurance Claims Processing: Introduction to Health Insurance Claims, Medical Billing Fundamentals, Healthcare Provider and Insurance Payer Systems, Patient Eligibility Verification, Benefits and Coverage Analysis, Medical Documentation Review, Diagnosis and Procedure Coding Basics, Electronic Claim Submission, Claim Denials and Appeals Management, Health Insurance Claim Quality Control.

Module 4: Property, Casualty and Life Insurance Claims: Introduction to Property Insurance Claims, Motor Insurance Claim Processing, Casualty and Liability Claims Management, Life Insurance Claim Procedures, Travel and Specialty Insurance Claims, Damage Assessment and Settlement Calculation, Claim Negotiation Techniques, Legal Aspects of Insurance Claims, Complex Claim Handling, Insurance Claim Case Studies.

Module 5: Claims Technology and Operational Management: Insurance Claims Management Software, Digital Claims Processing Systems, Electronic Data Interchange (EDI) in Insurance, Document Management and Workflow Automation, Claims Data Analysis and Reporting, Customer Relationship Management in Claims, Service Quality Management, Claims Audit and Compliance Monitoring, Data Security and Privacy in Claims Processing, Emerging Technologies in Insurance Operations.

Module 6: Advanced Claims Processing Practices and Professional Development: Advanced Claims Assessment Methods, Complex Claim Resolution Strategies, Claims Escalation and Dispute Management, Insurance Regulations and Risk Management, International Claims Processing Practices, Professional Communication Skills, Customer Service and Relationship Management, Claims Report Writing, Career Development and Industry Certifications, Practical Training and Capstone Claims Processing Project.

GSDCI Online Assessment Detail:

• Duration- 120 minutes.
• Number of Questions- 60.
• Number of Questions from each module: 10.
• Language: English.
• Exam Type: Multiple Choice Questions.
• Maximum Marks- 600, Passing Marks Above 40%.
• There is no negative marking in any module.

Benefits of the Professional Diploma

1. Globally Recognized Professional Diploma – Earn a professionally designed diploma that enhances your profile and demonstrates industry-relevant knowledge. Widely valued by employers, organizations, and institutions across multiple sectors.

2. Quality Learning with ISO-Certified Standards – Our training programs are developed under ISO-certified quality management practices, ensuring a structured, consistent, and high-quality learning experience.

3. Enhanced Career Opportunities – Strengthen your resume, improve your professional skills, and increase your potential for employment, career advancement, and new job opportunities.

4. Issued by a Non-Profit Skill Development Organization – The diploma is awarded by a mission-driven organization dedicated to promoting skill development, vocational education, and lifelong learning.

5. Comprehensive Learning Resources – Access quality study materials, e-books, practice assessments, mock tests, and learner support to help you successfully complete the program.

6. Secure Online Verification – Every diploma and marksheet is issued with a unique Enrolment ID and QR Code, enabling employers, institutions, and other stakeholders to instantly verify the authenticity of your credential online.

7. Lifetime Validity – The Professional Diploma is issued with lifetime validity and does not require periodic renewal, allowing you to showcase your achievement throughout your career.

8. Flexible Self-Paced Learning – Learn anytime and anywhere at your own pace, making it easy to balance your studies with work, business, or personal commitments.

9. Industry-Relevant Curriculum – The curriculum is designed to focus on practical knowledge, current industry trends, and real-world applications to improve workplace readiness.

10. Skill-Based Professional Qualification – Demonstrates your commitment to continuous professional development and validates your practical knowledge and skills in the subject area.