Vice President Claims And Audit
2 weeks 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 weeks 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 weeks 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 weeks 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 weeks 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 weeks 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
3 weeks 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 weeks 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...
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Vice President Claims and Audit
4 days ago
Bengaluru, India Antal International Full timeJob Description 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...
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Vice President Claims and Audit
2 weeks ago
Bengaluru, Karnataka, India, Karnataka 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
1 week ago
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...
