Lead / AVP - Health Claims

We are currently hiring for a Health Claims role with a New Age General Insurance Firm that is setting up their team in Mumbai.

The details are:

Industry: General Insurance (New Age General Insurance Firm)

Role: Health Claims.

Designation: Lead / AVP equivalent (open to discuss)

Location: Mumbai HO.

Job description:

1. Design and implement end-to-end health claims journeys across cashless, reimbursement, OPD, and other claim types.
2. Develop claims guidelines, SOPs, documentation standards, DOA, and maker-checker controls.
3. Support claims assessment, pre-authorizations, adjudication, complex claims, and grievance handling.
4. Drive claims governance, FWA controls, TAT, productivity, quality, and leakage management.
5. Support claims system configuration, UAT, automation, and continuous process improvement.