Role Overview:
We are looking for an experienced and proactive Claims Manager to oversee end-to-end claims management. The ideal candidate should possess strong stakeholder management skills, excellent presentation abilities, and well-established relationships with insurance companies and TPAs to ensure seamless claims processing and resolution.
Key Responsibilities:
- Manage the entire claims lifecycle (cashless & reimbursement) from initiation to closure
- Act as the primarypoint of contactfor escalations and ensure timely resolution
- Build and maintain strong relationships with insurers, TPAs, and hospital partners
- Drive faster turnaround time (TAT) and improve claimsefficiency
- Analyse claim trends and present insights, MIS, and reports to internal and external stakeholders
- Conduct client presentations, review meetings and training sessions
- Ensure adherence to policy terms, compliance, and documentation requirements
- Coordinate with internal teams for smooth claim processing and issue resolution
- Identify process gaps and implement continuous improvement initiatives
Key Requirements:
- 5–10 years of experience in health insurance claims management
- Strong network and working relationships with Insurers and TPAs
- Excellent presentation and communication skills
- Hands-on experience in claims adjudication and escalation handling
- Strong analytical and problem-solving abilities
- Ability to manage multiple stakeholders and high-pressure situations
