Prudent Insurance Brokers - Senior Manager - Claims - Employee Benefits

Job Title : Senior Manager - Claims (Employee Benefits)

Department : Claims & Operations

Reports to : Head - Claims / Operations

Job Summary :

The Senior Manager - Claims will be responsible for leading and overseeing the Employee Benefits (EB) claims team, ensuring smooth and efficient claims processing across cashless and reimbursement cases. The role requires strong stakeholder management with TPAs, insurers, and client HR teams, along with expertise in health insurance processes and regulatory frameworks. This position involves both strategic leadership and hands-on operational management to ensure SLA adherence, client satisfaction, and accurate claims resolution.

Key Responsibilities :

Team Leadership & Operations :

• Lead, mentor, and manage the EB claims team to achieve performance benchmarks and minimize escalations.
• Allocate workload effectively, monitor productivity, and ensure adherence to quality standards.
• Conduct regular training sessions to enhance team knowledge on policy terms, insurance guidelines, and process updates.
• Drive process improvements and automation initiatives to enhance efficiency.

Claims Management :

Stakeholder Management :

Compliance & Reporting :

Desired Profile / Candidate Graduate in any specialization (mandatory).

Skills & Competencies :

(ref : iimjobs.com)