480 Claims Management jobs in India

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 Manager – Claims Management to join our Experience team in Mumbai.

Manager - Claims Management

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

You could be the right candidate if you…

• Are a doctor by training (MBBS preferred /BAMS/BHMS/BDS)

• Have 07-10 years’ experience of health Insurance claims management with at least 2-3 years’ experience in Manager role.

• 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

• Managed team with people from Medical and Non-Medical background

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

I'm sharing you the detailed Job description of Business Process Delivery - Claims Management Processor at Accenture.

Qualification – B.COM Graduates only

Mode of Work(WFH or WFO) - WFO

Interview process – 2 Rounds of interview

Location – Mumbai

Shift Timing –  5.30pm to 3am 

Deliver end to end insurance claims processing services. Develop and deliver business solutions to improve insurance claims process.

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.

At Prudential Health India (PHI), we are on a mission to make Indians healthier, while bridging the health protection gap. This is a Zero to One team undertaking a greenfield health insurance deployment in India committed to building journeys that will truly empathize with the customer and offer a differentiated, bespoke experience.

To partner us in this mission, we are looking for a talented…

Manager/Assistant Manager – Travel Insurance Operations & Claims Management

As a Manager / Assistant Manager - Travel Insurance Process, your typical week might include the following:

You could be the right candidate if you…

This could be the gig for you if you…

Location: Mumbai

Title: Manager / Assistant Manager – Travel Insurance Operations & Claims management  

• Investigate insurance claims by gathering information from policyholders, witnesses, and other relevant sources.
• Analyze policy coverage and assess damages or losses incurred.
• Determine the extent of the company's liability and negotiate settlements with claimants.
• Prepare detailed reports documenting claim investigations, findings, and recommendations.
• Maintain accurate and organized claim files using company software systems.
• Ensure compliance with all relevant insurance regulations and company procedures.
• Provide clear and timely communication to policyholders throughout the claims process.
• Collaborate with legal counsel, repair facilities, and other service providers as needed.
• Identify potential fraud and follow established protocols for investigation.
• Continuously update knowledge of insurance products and claims handling best practices.
  

• Bachelor's degree in Business, Finance, or a related field, or equivalent work experience.
• Minimum of 3 years of experience in insurance claims adjustment.
• Strong understanding of insurance policies, claims investigation, and negotiation techniques.
• Excellent analytical and critical thinking skills.
• Exceptional interpersonal and communication abilities, both written and verbal.
• Proficiency in claims management software and standard office applications.
• Ability to work independently and manage multiple claims simultaneously.
• Strong negotiation and conflict-resolution skills.
• Customer-focused approach with a commitment to service excellence.
• Valid driver's license and willingness to travel to claim sites as required.

• Investigate insurance claims to determine coverage and liability.
• Interview claimants, witnesses, and relevant parties to gather information.
• Inspect damaged property and assess the extent of losses.
• Review policy documents and claim forms for accuracy and completeness.
• Negotiate settlements with claimants and their representatives.
• Prepare detailed reports on claim investigations and findings.
• Ensure compliance with insurance laws and regulations.
• Process payments and manage claim files efficiently.
• Provide excellent customer service to policyholders throughout the claims process.

• High school diploma or equivalent; Bachelor's degree preferred.
• Minimum of 2-4 years of experience as an insurance claims adjuster or in a related field.
• Knowledge of insurance policies, claims processing, and investigation techniques.
• Strong analytical and problem-solving skills.
• Excellent communication, negotiation, and customer service skills.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to work independently and manage a caseload effectively.
• Relevant insurance licenses or certifications are a plus.

• Investigate insurance claims promptly and thoroughly by gathering information, interviewing claimants and witnesses, and reviewing policy coverage.
• Assess the damage or loss reported and determine the extent of the company's liability based on policy terms and conditions.
• Negotiate settlements with policyholders and their representatives in a fair and efficient manner.
• Prepare detailed reports on claim investigations, findings, and recommendations.
• Maintain accurate and organized claim files, ensuring all documentation is complete.
• Liaise with legal counsel, repair shops, medical providers, and other third parties as needed.
• Adhere to all relevant insurance laws, regulations, and company policies.
• Manage a portfolio of claims, prioritizing tasks and ensuring timely resolution.
• Provide excellent customer service to policyholders throughout the claims process.
• Identify potential cases of fraud and escalate them for further investigation.
• Stay updated on industry best practices and changes in insurance legislation.
• Conduct on-site assessments of property damage or injury where necessary.
• Attend court hearings or depositions when required.

• Bachelor's degree in Finance, Business Administration, or a related field.
• Proven experience as a Claims Adjuster or in a similar role within the insurance industry.
• Strong understanding of insurance policies, claims processing, and legal/regulatory requirements.
• Excellent investigative, analytical, and problem-solving skills.
• Exceptional negotiation and communication abilities (both written and verbal).
• Proficiency in using claims management software and standard office applications.
• Ability to manage a caseload effectively and meet deadlines.
• High level of integrity and attention to detail.
• Customer-focused approach with a commitment to providing outstanding service.
• Valid Adjuster's license or willingness to obtain one is required.

• Investigate insurance claims thoroughly and objectively.
• Interview claimants, witnesses, and relevant parties.
• Inspect damaged property, vehicles, or other insured items.
• Review policy documents, claims forms, and supporting evidence.
• Determine the extent of liability and coverage under the policy.
• Calculate and negotiate fair claim settlements.
• Manage a caseload of claims from inception to closure.
• Maintain accurate and detailed claims records.
• Ensure compliance with all relevant insurance laws and regulations.
• Provide clear and timely communication to policyholders regarding their claims status.

• Bachelor's degree in Business Administration, Finance, or a related field.
• Proven experience as an Insurance Claims Adjuster or in a similar role.
• Knowledge of insurance policies, claims processing, and legal/regulatory requirements.
• Strong analytical, investigative, and problem-solving skills.
• Excellent negotiation and communication skills.
• Ability to manage time effectively and prioritize tasks.
• Proficiency in using claims management software.
• Valid insurance adjuster license (or willingness to obtain).
• Ability to conduct on-site inspections and client meetings.

• Investigate insurance claims by gathering information through interviews, policy analysis, and site inspections.
• Determine the extent of liability and coverage based on policy terms and conditions.
• Evaluate damages and calculate the settlement amount for claims.
• Negotiate settlements with policyholders, claimants, and legal representatives.
• Process claim documentation accurately and maintain detailed records.
• Ensure compliance with all relevant laws, regulations, and company policies.
• Provide excellent customer service and maintain positive relationships with clients.
• Collaborate with underwriters, legal counsel, and other departments as needed.
• Prepare reports and recommend claim disposition.
• Stay updated on industry trends and best practices in claims management.
• Attend training sessions to enhance knowledge of insurance products and claims procedures.
• Conduct physical inspections of property damage or injury sites.
• Assess the potential for subrogation or salvage.
• Manage a caseload of claims efficiently and prioritize tasks effectively.
• Utilize claims management software and tools to track and manage claims.

• Bachelor's degree in Business Administration, Finance, or a related field.
• Proven experience as a claims adjuster or in a similar role within the insurance industry.
• Strong understanding of insurance policies, regulations, and claims procedures.
• Excellent negotiation, communication, and interpersonal skills.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to analyze complex information and make sound judgments.
• High level of integrity and ethical conduct.
• Strong organizational and time management skills.
• Must possess a valid driver's license and a clean driving record.
• Ability to work under pressure and meet deadlines.
• Demonstrated customer service orientation.