Head - accident & health claims

3 days ago

Kota, India Taglynk Full time

Tag Lynk 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 Responsibilities Strategic 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 Stakeholders Internal: Product, U/W, Distribution, Customer Service, Technology, Compliance, Finance External: TPAs, Hospitals, Investigators, Providers, Corporates, Customers

  • Head - accident & health claims

    5 days ago

    Kota, India Taglynk Full time

    Tag Lynk 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 Responsibilities...

  • Claims Process Executive

    4 weeks ago

    Kota, India thinkbridge Full time

    About thinkbridgeWe are a global digital product development firm that helps growth-stage companies gain the technology sophistication and maturity of leading modern digital businesses. We differentiate ourselves by delivering exceptional quality at scale and speed with our thinkstack accelerators. We started with the vision of being able to build amazing...

  • Health insurance policy advisor

    2 weeks ago

    Kota, India GrayQuest Full time

    About Gray Quest Gray Quest is a rapidly growing Fin Tech company in the Indian education ecosystem. We specialize in providing EMIs for the $100 B+ education market, offering zero-cost installments with insurance and reward benefits. Currently, we work with over 5,000 educational institutions , including the top 10 school chains in the country, who trust us...

  • Radiology Denials Medical Coder

    2 weeks ago

    Kota, India Talentgigs Full time

    Job Title: Radiology Denials Coder Job Summary The Radiology Denials Coder is responsible for reviewing, analyzing, and resolving claim denials related to radiology services. This role ensures accurate CPT, ICD-10-CM, and HCPCS coding, identifies root causes of denials, and corrects or appeals claims in accordance with payer guidelines. The coder works...

  • Relationship Manager

    2 weeks ago

    Kota, Jaipur, Udaipur, India Care health insurance Full time

    Job Description To drive B2B sales for Care Health Insurance primarily through assigned private bank channels. This role involves building and nurturing strong relationships with bank branch heads and staff, coordinating sales efforts to generate new business, ensuring optimal branch activation, and consistently achieving sales targets to contribute to the...

  • Head of Token Strategy

    6 days ago

    Kota, India Brainwave Science Full time

    Location: Remote/Hybrid Employment Type: Full-time     Overview   Welcome to Basil Health — where Neuroscience meets Artificial Intelligence to redefine mental wellness.   We are a neurotechnology startup pioneering evidence-based, measurable mental wellness through EEG + AI-powered insights into stress, focus, anxiety, and relaxation.  Our...

  • Salesforce Architect

    2 weeks ago

    Kota, India Innova ESI Full time

    Salesforce Architect Experience- 12 Years10+ yearsof Salesforce experience, with at least3+ years in Health Cloudand proven multi-cloud delivery expertise. Strong expertise inSalesforce Data Cloud(identity resolution, harmonized data models, segmentation) andMarketing Cloud(Journey Builder, Audience Builder, Personalization). Demonstrated integration...

  • Iseries engineer

    2 weeks ago

    Kota, India Insight Global Full time

    Position: i Series Developer/Software Engineer Company: Insight Global Customer Location: Remote in India Max CTC Available: 30 LPA fixed Pay Requirements: MUST be able to join in 30 days or less for critical go live Minimum of 3 years of experience developing in i Series technologies inclusive of RPG/RPGLE Exposure to/Understanding of Synon - do not need to...

  • Power Bi Dashboard Expert

    1 week ago

    Kota, India Whatjobs IN C2 Full time

    We’re Hiring: Power BI Dashboard Expert (Remote – India, Temp/Hourly) Location: Remote (India) | Type: Temporary / Hourly Contract StafGo Health , a leading U.S.-based medical and dental Revenue Cycle Management (RCM) company, is looking for a Power BI expert with hands-on experience in U.S. healthcare RCM data and workflows . Responsibilities: Design...

  • Frontend Developer

    4 weeks ago

    Kota, India Persistent Systems Full time

    About Position:We are seeking a highly skilled Front-End Developer (Angular) to join our team in Pune. This role is ideal for professionals with deep expertise in Angular 15+, JavaScript, and front-end technologies, who are passionate about building responsive and scalable web applications.Role: Front-End Developer (Angular)Location: PuneExperience: 5 to 7...