Leadership Role: Claims Management

5 hours ago


Chennai, Tamil Nadu, India beBeeClaims Full time ₹ 1,50,00,000 - ₹ 2,00,00,000
Lead Claims Specialist

The position involves claims analysis and processing facilitation in coordination with different third-party administrators (TPAs) and insurance companies. This role requires strong leadership skills to lead a team and reduce escalations.

Responsibilities include:

  • Leading a team and minimizing escalations
  • Managing relations with TPAs/insurers to maintain claims service level agreements (SLAs)
  • Interacting with client human resources (HRs) to resolve claims-related queries, if required
  • Explaining clients about policy terms and conditions related queries over calls or emails
  • Reviewing denial claims sent by TPAs and ensuring that denials are made as per policy terms
  • Representing client claims to insurer/TPA in case of ambiguity in settlement/denial
  • Supporting analytics teams in data analytics
  • Managing assigned team members' day-to-day activities and productivity to ensure excellent client experience
  • Visiting insurer offices when necessary for approvals on claims
  • Supporting client servicing teams in claims-related issues, if needed

Desired profile:

  • Graduate with any specialization
  • 10-15 years of experience in managing enterprise business (EB) claims teams processing (cashless/reimbursements)
  • Familiarity with health insurance policy conditions
  • Familiarity with IRDA health regulations
  • Good communication skills
  • Problem-solving attitude
  • Team leadership
  • Mentoring skills
  • Decision-making abilities
  • Effective team management

We offer a dynamic work environment where you can utilize your skills and knowledge to drive results. If you have a passion for leading teams and resolving complex claims-related issues, this could be the perfect opportunity for you.



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