
Claims Management Professional
10 hours ago
About us, a FinTech innovator in the education ecosystem:
We transform the $100B+ industry through cutting-edge financial solutions.
Our flagship offering – monthly payment solutions for school and college fees – makes education more accessible, affordable, and rewarding for millions of families.
We partner with 5,000+ top educational institutions across the country, making us a trusted name in education-focused financial services.
Backed by respected investors and entrepreneurs, we're entering an exciting new phase.
We've launched a new insurance vertical focused on providing customised life and health insurance products to families within our network and beyond.
This is a high-impact opportunity to be at the forefront of building this vertical from scratch at a fast-growing fintech company.
Role Overview
As Health Insurance Claims Manager, you'll oversee and manage the end-to-end claims process for our customers.
You'll 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 experience.
- Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
- Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
- Collaborate with insurers, third-party administrators (TPAs), and hospitals to ensure quick and accurate claim resolutions.
- Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
- Ensure claims handling aligns with regulatory guidelines, insurer protocols, and internal compliance standards.
- Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
- Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.
A Bachelor's degree in Business, Finance, Insurance, or a related field is required.
ExperienceA minimum of 3–6 years of proven experience in health insurance claims management or related roles is necessary.
CertificationsAn IRDAI Health Insurance certification or equivalent is preferred.
SkillsThe ideal candidate will possess:
- 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.
The successful candidate will demonstrate:
- A customer-first mindset with empathy and professionalism.
- The ability to work under pressure and meet strict deadlines.
- Strong organisational skills and accountability.
Here's why we're different:
- 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 company.
- Trust & Transparency: Regulatory compliance, customer-first service, and honesty are non-negotiable.
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