Claims Manager

Role Overview:

We are looking for an experienced and proactive Claims Manager to oversee end-to-end claims management. The ideal candidate should possess strong stakeholder management skills, excellent presentation abilities, and well-established relationships with insurance companies and TPAs to ensure seamless claims processing and resolution.

Key Responsibilities:

• Manage the entire claims lifecycle (cashless & reimbursement) from initiation to closure
• Act as the primarypoint of contactfor escalations and ensure timely resolution
• Build and maintain strong relationships with insurers, TPAs, and hospital partners
• Drive faster turnaround time (TAT) and improve claimsefficiency
• Analyse claim trends and present insights, MIS, and reports to internal and external stakeholders
• Conduct client presentations, review meetings and training sessions
• Ensure adherence to policy terms, compliance, and documentation requirements
• Coordinate with internal teams for smooth claim processing and issue resolution
• Identify process gaps and implement continuous improvement initiatives

Key Requirements:

• 510 years of experience in health insurance claims management
• Strong network and working relationships with Insurers and TPAs
• Excellent presentation and communication skills
• Hands-on experience in claims adjudication and escalation handling
• Strong analytical and problem-solving abilities
• Ability to manage multiple stakeholders and high-pressure situations