Mumbai Maharashtra Insurance claims Jobs – 252 Open Jobs Today

PHI - Assistant Manager- Claims Management
Prudential plc —Mumbai, Maharashtra
- Full-time
- Analysis skills
- Communication skills
- Negotiation
Insurance Manager
Kataria Jewellery Insurance Consultancy —Mumbai District, Maharashtra
- ₹45,000 - ₹80,000 a month
- Full-time
- English
- Analysis skills
- Bachelor's degree
Quick apply
4d
Health Operations New Associate
Accenture —Navi Mumbai, Maharashtra
- Full-time
- English
- Bachelor's degree
- Communication skills
TPA Coordinator
LMH healthcare services Private Limited —Borivali, Mumbai, Maharashtra
- ₹20,000 - ₹35,000 a month
- Full-time
- Bachelor's degree
- In-person
Quick apply
Health Admin Services Associate
Accenture —Navi Mumbai, Maharashtra
- Full-time
- English
- Analysis skills
- Bachelor's degree
Client Partner - Accounts Receivable (AR Caller)
AccessHealthcare —Mumbai, Maharashtra
- Online application
- Anatomy knowledge
- Computer skills
- Typing
Health Admin Services New Associate
Accenture —Navi Mumbai, Maharashtra
- Full-time
Claim Processing Executive
Watchyourhealth.com India Private Limited —Mumbai, Maharashtra
- ₹25,000 - ₹27,000 a month
- Full-time
- English
- Analysis skills
- Bachelor's degree
Quick apply
Claims Manager (Fire & Property Insurance Domestic Claims)
Kataria Jewellery Insurance Consultancy —Marine Lines, Mumbai, Maharashtra
- ₹35,000 - ₹55,000 a month
- Full-time
- Analysis skills
- Bachelor's degree
- Organisational skills
Quick apply
8d
Health Operations Associate
Accenture —Navi Mumbai, Maharashtra
- Full-time
- English
- Bachelor's degree
Director, Global Markets Operations, India and South Asia Cluster Lead
Standard Chartered —Mumbai, Maharashtra
- Finance
- Bachelor's degree
- Communication skills
- Health insurance
- Paid sick time
6d
Health Admin Services Analyst
Accenture —Navi Mumbai, Maharashtra
- Full-time
- English
- Bachelor's degree
- Business Administration
payment posting
Medusind Solutions —Andheri East, Mumbai, Maharashtra
- ₹15,000 - ₹35,000 a month
- Full-time
- Microsoft Excel
- B.Sc
- Analysis skills
- Health insurance
Quick apply
Business Development Manager - Retirement and Pension
HDFC Life —Mumbai, Maharashtra
- ₹4,25,000 a year
7d
TPA Executive
Surana Hospital & Research Centre —Mumbai, Maharashtra
- ₹10,076.09 - ₹32,506.53 a month
- Full-time
- Bachelor's degree
- Business Administration
- In-person
Quick apply
audit executive (automobile dealership)
crowning consulting —Mumbai District, Maharashtra
- ₹45,000 - ₹55,000 a month
- Full-time
- Microsoft Excel
- ERP systems
- Finance
Quick apply
14d
Back Office Executive
Green Stapler —Andheri East, Mumbai, Maharashtra
- ₹20,000 - ₹30,000 a month
- Full-time
- Microsoft Word
- Microsoft Excel
- English
Quick apply
Claims Executive
Manobal HR services —Malad West Dely, Mumbai, Maharashtra
- ₹20,000 - ₹25,000 a month
- Full-time
- English
- Analysis skills
- Bachelor's degree
- Health insurance
- Paid sick time
Quick apply
TPA Executive
SUNACT CANCER INSTITUTE PRIVATE LIMITED —Thane, Maharashtra
- ₹30,000 - ₹40,000 a month
- Full-time
- Microsoft Excel
- Bachelor's degree
- In-person
Quick apply
Distribution Assistant
Novacare Healthcare Solutions Pvt Ltd —Mumbai, Maharashtra
- ₹35,000 - ₹45,000 a month
- Full-time
- Accounting
- QuickBooks
- In-person
- Health insurance
Quick apply
5h

I want to receive the latest job alerts for insurance claims in mumbai maharashtra

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

insurance claims jobs near mumbai maharashtra

Business Development Manager jobs in Mumbai, Maharashtra

Back Office Executive jobs in Andheri East, Mumbai, Maharashtra

Claims Assistant jobs in Mumbai, Maharashtra

Audit Associate jobs in Keshav Puram, Delhi, Delhi

Audit Associate jobs in Ernakulam District, Kerala

Audit Associate jobs in Bangalore City, Bengaluru, Karnataka

Internal Audit jobs in Tamil Nadu

Hr Associate jobs in Bengaluru, Karnataka

Audit Associate jobs in Kochi, Kerala

Audit Associate jobs in Delhi, Delhi

Insurance Manager jobs in Salt Lake, Kolkata, West Bengal

Insurance Manager jobs in Guindy, Chennai, Tamil Nadu

Hr Manager jobs in Tamil Nadu

Hotel General Manager jobs in Bengaluru, Karnataka

Insurance Manager jobs in Madhya Pradesh

Insurance jobs in Kochi, Kerala

Insurance Manager jobs in Gujarat

Service Associate jobs in Delhi

Service Associate jobs in Panaji, GOA

Service Associate jobs in Gurgaon, Haryana

PHI - Assistant Manager- Claims Management

Prudential plc -
Mumbai, Maharashtra

Apply Now

Job details

Full-time

Qualifications

Assistant manager experience
Analysis skills
CPT coding
BAMS
Communication skills
Negotiation

Full job description

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Prudential (UK) in partnership with HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer.

This joint venture will combine Prudential's global expertise in insurance and financial services with HCL Group’s experience in technology and healthcare solutions.

Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India’s first World Cup Victory!

Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience.

To partner with us in this mission, we are looking for a talented Assistant Manager – Claims Management to join our Experience team in Mumbai.

Assistant Manager – TPA Claims Management

As an Assistant Manager Claims, your typical week might include the following:

Guiding TPA processing team by providing medical opinion for Health Insurance Claims
Ensure claims of valid settlements are made according to the company practice and procedures.
Processing and approving medical claims pertaining to Indemnity, Benefit for both Group and Retail, with sharp FWA and Loss minimization approaches.
Thorough on the compliance and regulatory requirements and implementation in the claims process.
Case management of potential cases to Network team, maintaining data of referred/saving achieved/impact against cashless outgo.
Automation and rule driven decision making with timely update of benefit in TAT / TMS / Transaction
Create and reviewing claim simplification guidelines to Improve TAT, Minimize transaction.
Medical decisioning and guidance to the team
Audit of TPA processed claims and also Inhouse processed claims.
Regulatory compliances – Claim processing guideline as per compliance and timely implementation of any New Circular.
Train TPA teams – Timely Training of TPA for new benefit, process change, Understanding and claim Philosophy as per PHI standard.
Benefit claims – Well versed with processing of Benefit claims, Creating SOP, Pay-out framework to Nominee/Legal heir.
Collaborate with FWA Manager to provide inputs from agencies for efficient Fraud restriction and necessary checks and balances in system.
Re-UW opinion for non-disclosure cases – Training to Team for indicated cases for Re-UW referral, tracking and corrective action basis UW decision.
Extend support to the sales/distribution – Separate prioritization que for green channel, Specific Agent, Broker.
Set up and create robust governance to manage TPA process with great efficiency.
Proficient with medical terms & systems (including ICD/CPT/PCS codes).

You could be the right candidate if you…

Are a doctor by training (/BAMS/BHMS/BDS)
Have 03-05 years’ experience of health Insurance claim processing management with at least 1-2 years’ experience as team leader managing and holding responsibility daily claim flow.
Understands the TPA ecosystem and has experience of managing TPA model (Preferred)
Have startup experience or setting up a team from scratch (Preferred but not mandatory)
Should be a decisive & creative individual.
Should be able to make quick decisions and have good judgment and analytical skills
Have an excellent verbal and written communication skills and strong negotiation skills.
Always open to embracing change and be able to manage it

This could be the gig for you if you…

Are passionate about consumer behaviour and culture; enjoy spending time with customers to understand what they really want. Have an attentive ear listen to new ideas.
Like to work in a culture where everyone can see what others are doing
Take help from others when stuck and encourage others when there are setbacks
Take full responsibility for your own output while thinking wing to wing across the organization; to solve for the customer
Have strong clinical knowledge and clinical decision-making skills
Have built best in class processes from a scratch.
Are passionate about leveraging digital tools to transform customer experience What can make you extra special.

What can make you extra special

It’s a great if you have already read books like Blue Ocean strategy & Zero to One. Before you saw them mentioned here.
You have real stories to tell about how your team, and you challenged convention and took the path less travelled.
We are keen to listen to your story; doesn’t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly.

Location: Mumbai

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

Apply Now

Refine Your Search

insurance claims jobs in mumbai maharashtra

PHI - Assistant Manager- Claims Management

Insurance Manager

Health Operations New Associate

TPA Coordinator

Health Admin Services Associate

Client Partner - Accounts Receivable (AR Caller)

Health Admin Services New Associate

Claim Processing Executive

Claims Manager (Fire & Property Insurance Domestic Claims)

Health Operations Associate

Director, Global Markets Operations, India and South Asia Cluster Lead

Health Admin Services Analyst

payment posting

Business Development Manager - Retirement and Pension

TPA Executive

audit executive (automobile dealership)

Back Office Executive

Claims Executive

TPA Executive

Distribution Assistant

I want to receive the latest job alerts for insurance claims in mumbai maharashtra

Related Searches

Explore jobs in more locations

Jobseeker tools

Employer Tools

Browse

Stay Connected