Roles Responsibilities

About the Role

RiskBirbal Insurance Broker Pvt. Ltd. is seeking an experienced and customer-focused Manager Health Insurance, Accidental Insurance, Term Life Claims Servicing to lead the Department. The ideal candidate will be responsible for managing end-to-end claims, policy servicing operations, team performance, client satisfaction, and coordination with insurance companies and TPAs. The role requires strong leadership, excellent client relationship management, and in-depth knowledge of health insurance processes.

Key Responsibilities

Lead and manage the Claims Servicing team to ensure smooth daily operations.

Oversee end-to-end processing of reimbursement and cashless health insurance claims.

Coordinate with insurance companies, TPAs, hospitals, and clients for timely claim processing and settlement.

Monitor claim status, follow up on pending cases, and ensure closure within defined TAT.

Handle escalated customer queries, complaints, and complex claim cases with effective resolution.

Manage policy servicing activities, including endorsements, renewals support, policy corrections, additions, deletions, and policy-related requests.

Ensure complete and accurate claim documentation before submission to insurers or TPAs.

Maintain robust relationships with insurance companies, TPAs, hospitals, and corporate clients.

Monitor departmental KPIs, claim ageing, TAT, and service quality metrics.

Prepare daily, weekly, and monthly MIS reports and performance dashboards.

Ensure all claim and servicing activities are accurately updated in the CRM system.





Develop and implement SOPs to improve operational efficiency and customer experience.

Train, mentor, and evaluate team members to enhance productivity and service quality.

Coordinate with Sales, Operations, Accounts, and IT teams for seamless customer servicing.

Ensure compliance with IRDAI regulations, insurer guidelines, and company policies

Experience and Qualifications

Required Skills

Strong knowledge of EB policies claims and policy servicing.

Good understanding of cashless and reimbursement claim processes.

Experience working with TPAs, hospitals, and health insurance companies.

Excellent leadership and team management skills.

Solid customer handling, negotiation, and grievance resolution abilities.

Advanced knowledge of MS Excel, MIS reporting, CRM systems, and operational reporting.

Excellent communication, analytical, and problem-solving skills.

Ability to manage multiple priorities and meet strict service timelines.

Qualification

Bachelors Degree in any discipline.

MBA/PGDM will be preferred.

Insurance certifications (III/Fellowship/Health Insurance-related certifications) will be an added advantage.

Preferred Experience

5 10 years of relevant experience in Health Insurance Claims Servicing with an Insurance Broker, Health Insurance Company, or TPA.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 Manager - Claims & Servicing (Delhi)
🏢 Riskbirbal Insurance Brokers
📍 Delhi