This role involves overseeing the entire claims process from registration to settlement while ensuring strict adherence to SLAs and regulatory guidelines
Job Summary
This role involves overseeing the entire claims process from registration to settlement while ensuring strict adherence to SLAs and regulatory guidelines.
The successful candidate will manage daily floor operations, including team rostering, shift planning, and dynamic resource allocation to meet demand.
As part of a zero-to-one greenfield team, you will drive process optimization and collaborate with IT to introduce automation and RPA solutions.
Matching Summary
This role involves overseeing the entire claims process from registration to settlement while ensuring strict adherence to SLAs and regulatory guidelines.
Skills & Requirements
Must-have
7-12 years health insurance claims experience
3+ years managerial role in claims
Proficiency in Excel SQL and BI tools
Deep understanding of IRDAI regulations
Experience managing TPA ecosystem
Strong leadership and team coaching skills
Nice-to-have
Startup or greenfield team setup experience
Lean Six Sigma Green Belt certification
Clinical knowledge and decision-making skills
Familiarity with Blue Ocean strategy concepts
Experience digitizing manual workflows
Strong negotiation and stakeholder management
Key Requirements
Graduate/Postgraduate in Healthcare Management or related field
7-12 years experience in health insurance claims operations
At least 3 years in a managerial role
Understanding of IRDAI regulations and health insurance products