Health Insurance Claims Manager

Job Description: Health Insurance Claims Manager

Location: Mumbai

Experience: 2-3 years in Health Insurance

Employment Type: Full-time

Joining: Immediate

About GrayQuest

GrayQuest is a rapidly growing FinTech company in the Indian education ecosystem. We specialize in providing EMIs for the $100B+ 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 to power their fee payments through convenient monthly installments.

Backed by leading investors and seasoned fintech visionaries, we are a Series B start-up with a strong reputation in the financial ecosystem. Our funding is driven by industry leaders such as Kunal Shah & Miten Sampat (CRED), Nitin Gupta (UNI), Sumit Maniyar (Rupeek), and Sujeet Kumar (Udaan), who inspire our journey of growth and innovation. With partnerships across 5,000+ premier educational institutions nationwide, weve established ourselves as a trusted name in education-focused financial services.

Role Overview

We are seeking an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for our customers. In this role, 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, on-site role based in Mumbai with immediate joining.

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

Education

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

Experience

• 2–3 years of proven experience in health insurance claims management or related roles.

Certifications

• IRDAI Health Insurance certification 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 GrayQuest is 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.
• Trust & Transparency: IRDAI compliance, customer-first service, and honesty are non-negotiable.