Role Overview

Claims lead for the corporate claims vertical. To manage the entire corporate Claims team and oversee end-to-end claims operations. This role is critical in ensuring our corporate partners and their employees receive a seamless, claims experience. You will be responsible for driving operational excellence, maintaining Evens quality standards, and leading a high-performing team in a fast-paced, digital-first environment.

Key Responsibilities

As the lead, your core responsibilities will include:

- Monitoring Claims: Closely supervising the end-to-end lifecycle of OPD and wellness claims to ensure accuracy and compliance.
- TAT Maintenance: Taking full ownership of the team's Turnaround Time (TAT) to ensure claims are processed swiftly, reliably & within the.
- Time Adherence: Managing team schedules and workflow to ensure consistent operational coverage and productivity.
- Daily Targets: Setting and driving the team to meet daily throughput goals while maintaining high quality benchmarks.
- Escalation Handling: Acting as the primary point of contact for complex B2B claim disputes,



ensuring professional and timely resolutions.
- Conduct regular quality audits, feedback sessions, and team coaching.
- Identify operational gaps, fraud indicators, and process improvement opportunities.
- Ensure compliance with internal policies, audit requirements, and regulatory guidelines.
- Support hiring, onboarding, and training of new team members.

Requirements

- 6+ years of experience in claims processing, health insurance, TPA operations, or healthcare operations.
- Prior team handling or leadership experience required.
- Strong understanding of medical terminologies, OPD claims, and health insurance processes.
- Experience managing high-volume claims operations in a fast-paced environment.
- Robust analytical, problem-solving, and stakeholder management skills.
- Excellent communication, team management, and operational coordination abilities.
- Hands-on experience with CRM or claims management systems.
- Preferred qualifications- MBBS, BDS, BHMS, BAMS, Nursing or B Pharm.

📌 Manager - Health Claims (Bengaluru)
🏢 Even Healthcare
📍 Bengaluru