Health Insurance Claims Manager

24 hours ago

Tiruppur, Tamil Nadu, India beBeeInsurance Full time US$ 8,00,000 - US$ 15,00,000
Health Insurance Claims Manager Job

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

This is a full-time, on-site role based in Mumbai with immediate joining.

About the Role

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.

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

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 IRDAI 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:
  • Bachelor's degree in Business, Finance, Insurance, or related field.
  • 3–6 years of proven experience in health insurance claims management or related roles.
  • IRDAI Health Insurance certification or equivalent preferred.
Benefits:
  • A competitive salary and benefits package.
  • An opportunity to work with a leading fintech company.
  • A collaborative and dynamic work environment.
Why This Opportunity?
  • 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: IRDAI compliance, customer-first service, and honesty are non-negotiable.

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