Head - Accident & Health Claims
4 days ago
TagLynk Careers, hiring partner for a leading insurance organization, is looking for a senior leader to drive Accident & Health Claims Strategy & Operations. This role is ideal for seasoned professionals with deep expertise in health insurance claims, fraud mitigation, provider network management and regulatory compliance.Key ResponsibilitiesStrategic Leadership- Build and drive end-to-end Accident & Health Claims strategy, frameworks and processes. - Ensure compliance with latest health insurance regulations; implement process refinements. - Lead the move towards paperless, automated claims settlement with superior TAT & customer experience. - Design and monitor performance metrics for TPAs and internal claims teams. - Collaborate with technology teams to build/enhance claims systems & automation. - Build strong partnerships with external stakeholders: TPAs, investigators, hospitals, OSPs, providers. - Drive continuous improvement, best practices, and customer-first delivery.Financial & Risk Management- Partner with audit & fraud teams to implement fraud prevention and loss-mitigation frameworks. - Manage claims budgets, average claims cost and cost-containment initiatives. - Analyze ICR, medical data and portfolio trends; drive proactive risk control. - Support product, U/W and actuarial teams with insights for guideline finalization. - Lead periodic reporting for internal & regulatory stakeholders.Functional & Operational Excellence- Lead teams managing claims processing, customer queries, complaints, reserving & registration. - Oversee adjudication of complex claims: indemnity, critical illness, accidental death. - Manage network providers, evaluate & empanel TPAs/OSPs, drive performance management. - Partner closely with product/business teams to strengthen service capability.People Leadership- Drive a culture of accountability, high performance and continuous learning. - Set goals, mentor teams, review performance, and build future leaders in claims operations. - Strengthen collaboration across cross-functional internal teams.Desired Profile- MBBS / BAMS / BHMS / B.Pharm preferred; or any graduate with health insurance certifications. - 15–20 years of experience in health insurance / TPA / wellness / healthcare domains. - Strong exposure to claims operations, adjudication, medical review, fraud control, underwriting basics, hospital administration, and provider network management. - Proven leadership in handling large teams and multi-stakeholder environments. - Excellent analytical, communication, negotiation and people management skills.Key StakeholdersInternal: Product, U/W, Distribution, Customer Service, Technology, Compliance, FinanceExternal: TPAs, Hospitals, Investigators, Providers, Corporates, Customers
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Head - Accident & Health Claims
1 week ago
Delhi, India Taglynk Full timeTagLynk Careers, hiring partner for a leading insurance organization, is looking for a senior leader to drive Accident & Health Claims Strategy & Operations . This role is ideal for seasoned professionals with deep expertise in health insurance claims, fraud mitigation, provider network management and regulatory compliance.Key ResponsibilitiesStrategic...
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Head of Claims
4 days ago
New Delhi, India RightMatch HR Services Private Limited Full timeThe role is with a leading General Insurance company.About the RoleThe organization is seeking a seasoned Head of Claims to lead its Health Insurance Claims function. The role focuses on driving operational excellence, regulatory compliance, and digital transformation across the claims lifecycle.Responsibilities- Lead and enhance claims systems, rule...
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Claims Representative
2 weeks ago
New Delhi, India Nucleon Health Full timeJoin Our Team as a Health Insurance Claims Executive!Location: Vadodara |Full-time | On-siteRole OverviewWe’re looking for a Health Insurance Claims Executive who is passionate about helping people and ensuring a smooth claim experience. In this role, you’ll act as the bridge between customers, hospitals, and insurers—handling claims with accuracy,...
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Claims Representative
3 weeks ago
New Delhi, India Nucleon Health Full timeJoin Our Team as a Health Insurance Claims Executive!Location:Vadodara |Full-time | On-siteRole Overview We’re looking for aHealth Insurance Claims Executivewho is passionate about helping people and ensuring a smooth claim experience. In this role, you’ll act as the bridge between customers, hospitals, and insurers—handling claims with accuracy,...
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Non Health Claim Executive
2 weeks ago
New Delhi, India Riskbirbal Insurance Brokers Pvt Ltd Full timeWe are seeking a highly organized and detail-oriented Non Health claims Executive to facilitate the smooth processing of insurance claims for our clients. As a Claims Executive, you will be responsible for assisting insured individuals in filing and managing their claims, ensuring adherence to policy terms and conditions, and coordinating with surveyors and...
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Non Health Claims
2 weeks ago
Janakpuri, Delhi, Delhi, India Insurance Broking Company Full time**Job Summary** Hope you are receiving this mail with good health. Please find below the Job Description. - Taking care of all Non - Health Claims - Claim Documentation verify and process - Able to understand claim nature and act accordingly - Marine/Fire/Burglary claim documents understanding required - Know how to work in MS Excel and...
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Medical Officer – TPA Claim Process
2 days ago
New Delhi, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: VadodaraReporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination between...
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Claims Investigations Manager
4 weeks ago
New Delhi, India SKD HEALTH ALLIED SERVICES Full timeAbout the Company SKD Health Allied Services is a reputed organization and a pioneer in the industry of claims investigations across south India and Maharashtra, having its offices at Chennai , Bangalore , Ernakulam , Madurai, Hyderabad and PuneNeed talented, experienced doctors and para medics for the role of claims manager, who has a responsibility of...
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Claims Manager
2 weeks ago
New Delhi, India Anand Rathi Insurance Brokers Ltd Full timeFunction PurposeThe Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, maintain client satisfaction, and uphold the credibility of the organization by adhering to ethical and legal standards. Role Purpose The purpose of...
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Claims Manager
6 days ago
New Delhi, India Anand Rathi Insurance Brokers Ltd Full timeFunction Purpose The Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, maintain client satisfaction, and uphold the credibility of the organization by adhering to ethical and legal standards. Role Purpose The purpose...
