Lead - HR Operation (Medical Insurance)

Role & responsibilities

• Own the end-to-end administration of Group Medical Insurance (GMC), Group Term Life (GTL), Group Personal Accident (GPA), and other employee benefit programs.
• Manage open enrollment, mid-year additions/deletions, dependent management, and policy endorsements.
• Ensure accurate employee and dependent data management across HRMS and insurer portals.
• Monitor policy utilization, insurer performance, and claim ratios.
• Oversee cashless and reimbursement claim processes.
• Act as the escalation point for complex and high-value claims.
• Track claim turnaround time (TAT) and drive continuous improvements.
• Publish regular claim analytics and insights.
• Manage relationships with insurers, brokers, TPAs, wellness partners, and other benefit vendors.
• Conduct governance meetings with vendors and monitor SLAs.
• Design and execute employee communication campaigns.
• Manage employee queries through HR helpdesk, email, and ticketing platforms.
• Improve employee satisfaction through simplified benefit processes.

Preferred candidate profile

Candidate have 3 + years in medical insurance handling