Health Insurance Operations Leader

5 days ago

Thāne, Maharashtra, India beBeeClaimsManager Full time ₹ 9,00,000 - ₹ 12,00,000

About our organization

We are a financial technology innovator in India's education ecosystem, transforming the industry through our financial solutions.

Our flagship offering makes education more accessible, affordable, and rewarding for millions of families. We partner with top educational institutions across the country.

We're entering an exciting new phase with a new insurance vertical focused on providing customised life and health insurance products to families within our network and beyond.

As part of our strategic expansion, we've launched a new opportunity to be at the forefront of building this vertical from the ground up.

Job Overview

We seek an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for our customers.

You will serve as the primary liaison between clients, insurers, TPAs, and healthcare providers to ensure claims are handled smoothly, accurately, and on time.

The ideal candidate will have a strong background in health insurance claims management, excellent problem-solving skills, and the ability to deliver a seamless, customer-focused experience.

This is a full-time role based in Mumbai.

Key Responsibilities

  • Claims Processing & Adjudication: Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
  • Customer Coordination: Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
  • Insurance & TPA Liaison: Collaborate with insurers, third-party administrators (TPAs), and hospitals to ensure quick and accurate claim resolutions.
  • Issue Resolution: Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
  • Compliance & Accuracy: Ensure claims handling aligns with regulatory guidelines, insurer protocols, and internal compliance standards.
  • Monitoring & Reporting: Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
  • Process Improvement: Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.

Requirements

Education

  • Bachelor's degree in Business, Finance, Insurance, or related field.

Experience

  • 3–6 years of proven experience in health insurance claims management or related roles.

Certifications

  • Regulatory certification in health insurance or equivalent preferred.

Skills

  • Strong knowledge of health insurance policies, products, and claims procedures.
  • Excellent communication, negotiation, and customer-handling skills.
  • High attention to detail with strong analytical and problem-solving abilities.
  • Proficiency in MS Office and claims management/CRM systems.

Attributes

  • Customer-first mindset with empathy and professionalism.
  • Ability to work under pressure and meet strict deadlines.
  • Strong organizational skills and accountability.

Why Join Us?

Here's why our organization stands out:

  • Advice First, Always: We provide guidance, not pressure—helping families make confident decisions.
  • Build Something New: Be part of creating a vertical from scratch at a fast-growing fintech.
  • Trust & Transparency: Regulatory compliance, customer-first service, and honesty are non-negotiable.

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