Claims Management Leader
RightMatch HR Services Private LimitedRepublic Of India, IN12 hours ago
Job description10+ years of health insurance claims experience, with strong leadership exposure. Expertise in medical coding (ICD-10, CPT), claims assessment, and billing processes. Proven ability to work with claims management systems, automation tools, OCR, RPA, workflow engines, or AI / ML-led solutions. Strong analytical, decision-making, and stakeholder management skills.
The role is with a leading General Insurance company.
About the Role
The organization is seeking a seasoned Head of Claims to lead its Health Insurance Claims function. The role focuses on driving operational excellence, regulatory compliance, and digital transformation across the claims lifecycle.
Responsibilities
- Lead and enhance claims systems, rule engines, and automated workflows.
- Oversee end-to-end claims operations—from intimation to settlement.
- Guide resolution of complex and high-value claims.
- Drive technology adoption, process automation, and efficiency improvements.
- Ensure full compliance with IRDAI regulations and audit requirements.
- Monitor KPIs, claims performance, and regulatory reporting (IRDAI / IIB).
- Collaborate with underwriting, legal, product, IT, TPAs, and hospitals.
- Manage escalations and ensure superior customer experience.
Qualifications
Required Skills
If you are interested for the same then connect with saloni@rightmatch.co.in - linkedin.Com / in / salonikamdar
Create a job alert for this search
Management Leader • Republic Of India, IN