Phi - Manager- Claims Management

Prudential Assurance UK

Mumbai, India
Medical degree mbbs preferred
7-10 years health insurance claims experience
2-3 years management role experience
This role involves guiding a processing team with medical opinions to ensure valid settlements according to company practices

Job Summary

  • This role involves guiding a processing team with medical opinions to ensure valid settlements according to company practices.
  • The position requires creating detailed standard operating processes and managing automation to improve turnaround time and minimize transactions.
  • Candidates must be decisive individuals capable of managing teams from both medical and non-medical backgrounds in a zero-to-one startup environment.

Matching Summary

This role involves guiding a processing team with medical opinions to ensure valid settlements according to company practices.

Skills & Requirements

Must-have

  • Medical degree MBBS preferred
  • 7-10 years health insurance claims experience
  • 2-3 years management role experience
  • Proficiency in ICD/CPT/PCS medical codes
  • Experience managing TPA ecosystem

Nice-to-have

  • Startup or greenfield team setup experience
  • Knowledge of Blue Ocean strategy and Zero to One
  • Strong clinical decision-making skills
  • Passion for consumer behavior and culture
  • Experience leveraging digital tools for transformation

Key Requirements

  • MBBS / BAMS / BHMS / BDS qualification
  • 7-10 years total experience in health insurance claims
  • 2-3 years in a Manager-level role
  • Experience setting up teams from scratch (preferred)

Work Rights

Not specified

Tailored Resume

Cover Letter