Vice President Claims and Audit
3 days ago
Job Summary:We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance with internal and external audit standards. A medical background (MBBS) is essential to effectively assess the clinical validity of claims and guide the medical audit team.Key Responsibilities:•Provide strategic leadership for health insurance claims processing operations, ensuring efficiency, accuracy, and timely settlements.•Oversee risk management initiatives related to claim adjudication, fraud prevention, and abuse detection.•Develop and implement a fraud detection framework using a combination of medical insight, data analytics, and audit mechanisms.•Manage complex and high-value claims, ensuring alignment with policy terms and medical appropriateness.•Collaborate with internal stakeholders (underwriting, legal, medical officers, technology, etc.) to drive cross-functional improvements.•Lead, mentor, and grow a multidisciplinary team comprising claims assessors, medical reviewers, and fraud investigators.•Interface with auditors and regulatory bodies to ensure compliance and readiness for audits.•Analyze claims trends to identify potential risks, fraud patterns, and operational improvement opportunities.•Support system automation and digitization initiatives to streamline claims workflows and reduce processing time.Required Qualifications & Skills:•MBBS degree is mandatory; additional qualifications in insurance, hospital administration, or risk management are a plus.•Minimum 12–20 years of experience in health insurance claim management.•Deep understanding of health insurance claim lifecycle, policy terms, medical coding, and TPA management.•Strong grasp of audit processes, healthcare regulations, and fraud investigation techniques.•Proven ability to lead and manage high-performance teams.•Excellent analytical, decision-making, and communication skills.•Proficient in using health insurance platforms, data analytics tools, and reporting dashboards.Preferred Experience:•Experience working with large insurance providers or TPAs.•Familiarity with Indian health insurance regulatory environment (IRDAI guidelines, etc.).
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Vice President Claims and Audit
3 days ago
Bengaluru, India Antal International Full timeJob Summary: We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President Claims and Audit
3 days ago
Bengaluru, India Antal International Full timeJob Summary: We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President Claims and Audit
3 days ago
Bengaluru, India Antal International Full timeJob Summary:We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President Claims and Audit
3 days ago
Bengaluru, India Antal International Full timeJob Summary:We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice president claims and audit
3 days ago
Bengaluru, India Antal International Full timeJob Summary:We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President Claims And Audit
2 days ago
Bengaluru, India Whatjobs IN C2 Full timeJob Summary: We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President Claims and Audit
4 days ago
Bengaluru, Karnataka, India Antal International Full time ₹ 20,00,000 - ₹ 60,00,000 per yearJob Summary:We are seeking a dynamic and experienced professional to lead health insurance claim management operations, with a specialized focus on risk mitigation, fraud investigation, and process efficiency. The Vice President – Claim Management will oversee end-to-end claim processing, implement robust fraud detection frameworks, and ensure compliance...
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Vice President
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Bengaluru, Karnataka, India Genpact Full time ₹ 12,00,000 - ₹ 36,00,000 per yearInviting applications for the role of Vice President - Claims Subject Mater Expert – P&C Insurance IndustryIn this role, you are required to have strong expertise in the P&C claims domain to develop solutions for Requests for Proposals (RFPs), provides functional support to create new capabilities and digital solutions, and support the team in claims...
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Vice President
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Bengaluru, Karnataka, India Genius Consultants Full time ₹ 12,00,000 - ₹ 36,00,000 per yearWe're Hiring: Vice President / Senior General Manager MIVAN Framework (Bangalore)Are you a results-driven construction professional with a strong background in MIVAN framework technology? We are looking for an experienced Vice President / Senior General Manager to lead and manage large-scale projects in Bangalore. Key Requirements:Minimum 10 years of...
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Vice President Marketing And Sales
2 weeks ago
Bengaluru, Karnataka, India Mentric Training and Consulting Pvt Full time ₹ 12,00,000 - ₹ 36,00,000 per yearCompany DescriptionMentric Training and Consulting Pvt. Ltd. focuses on providing holistic training solutions across various sectors, emphasizing technical skills, soft skills, and job-oriented training programs. With strong expertise in the Facility Management Sector, Mentric Training emphasizes learning journeys for individuals, teams, and organizations....
