Assistant Manager - Claims

Job Summary:

We are looking for an experienced and detail-oriented Assistant Manager – Claims to join our Claims team. The ideal candidate will have 4–5 years of experience in insurance claims handling or operations, with strong expertise in managing insurer relationships, handling both reimbursement and cashless claims, and driving adherence to Turnaround Time (TAT) and Service Level Agreements (SLAs).

Key Responsibilities:

• Insurer & Internal Query Management Act as the primary contact for insurer communications and internal support queries. Ensure timely resolution of escalations and claim-related issues.

• Claims Processing – Reimbursement & Cashless Manage end-to-end processing of reimbursement claims, including documentation, validation, and settlement. Generate and send cashless debit notes to insurers and follow up for approvals and payments.

• Insurer Relationship Management Maintain strong working relationships with insurers (Health or General Insurance). Coordinate regularly to address claim-related issues and streamline processes.

• TAT Monitoring & SLA Compliance Monitor claims turnaround time (TAT) and ensure compliance with internal and external SLA benchmarks. Identify delays or inefficiencies and implement corrective actions to improve process efficiency.

• Reporting & Process Improvement Prepare regular reports on claims performance, TAT, and issue trends. Recommend and support initiatives for process enhancement and operational excellence.

Experience & Qualifications:

• Experience: 4–5 years in Claims Handling or Insurance Operations

• Industry Background: Experience with Insurance Companies or Third Party Administrators (TPAs) preferred Exposure to Health or General Insurance is highly desirable

• Education: Bachelor's degree in any discipline (preferred: Insurance, Healthcare, or Business Administration)

• Skillset: In-depth knowledge of reimbursement and cashless claim processes Strong relationship management and coordination skills Familiarity with TAT and SLA monitoring Proficiency in MS Office and claims management systems Strong communication, analytical, and problem-solving skills