Job Description: Servicing Lead Group Health Business

Role Overview

The Servicing Head – Group Health Business will be responsible for leading the end-to-end post-policy issuance servicing function for group health insurance clients, with a strong focus on broker-led servicing, claims coordination, endorsements, escalations, policy administration, client experience, and service governance. The role is critical in ensuring that corporate clients, employees, brokers, and internal stakeholders receive timely, transparent, and high-quality service support throughout the policy lifecycle.

Key Responsibilities

1. Post-Policy Issuance Servicing Leadership

- Own the complete servicing lifecycle after policy issuance, including onboarding, policy handover, employee communication support, endorsements, member additions/deletions, CD balance tracking, premium adjustments, and servicing documentation.
- Define and implement service standards, SOPs, escalation matrices, and turnaround time frameworks for group health clients.
- Ensure seamless coordination between brokers, corporate HR teams, internal operations, underwriting, finance, claims, and TPA/network teams.

2. Broker & Corporate Client Servicing

- Act as the senior servicing interface for key brokers and large corporate group health clients.
- Build strong working relationships with broker servicing teams to ensure consistent service delivery and timely issue resolution.
- Conduct periodic service review meetings with brokers and clients covering claims status, endorsements, grievances, open issues, TAT performance, and utilization trends.
- Support sales and relationship teams during renewals by providing servicing insights, claim experience inputs, and client feedback.

3. Claims Servicing & Escalation Management





- Oversee claim-related servicing for group health clients, including cashless, reimbursement, deficiency, repudiation, query resolution, and critical claim escalations.
- Coordinate with claims, medical, TPA, network hospital, and broker teams to ensure faster resolution of complex and high-impact cases.
- Track claim ageing, pending documents, high-value claims, grievance cases, and escalation trends through structured MIS dashboards.
- Identify recurring claim issues and recommend process improvements, communication changes, or policy-level interventions.

4. Endorsement & Policy Administration

- Drive timely processing of endorsements such as member addition, deletion, correction, dependent updates, sum insured changes, employee data corrections, location changes, and other policy modifications.
- Ensure billing, premium, refund, and CD-related endorsements are coordinated accurately with finance and operations teams.
- Maintain strong control over endorsement backlogs, data quality, reconciliation, and broker/client communication.

5. Service Governance, MIS & Analytics

- Develop servicing dashboards covering claims status, endorsement TAT, open escalations, grievance ageing, broker-wise service performance, and client-level issue trends.
- Publish regular MIS reports to internal leadership, brokers, and client stakeholders as required.
- Use servicing data to identify process bottlenecks, risk areas, high-frequency issues,



and opportunities for automation or self-service.
- Ensure adherence to agreed service levels and proactively flag exceptions to leadership.

6. Team Leadership & Process Excellence

- Lead, mentor, and develop the group servicing team across claims support, endorsements, client servicing, and broker coordination.
- Set transparent productivity, quality, TAT, and customer experience metrics for the servicing team.
- Drive training on group health products, policy terms, claims processes, regulatory requirements, service etiquette, and broker management.
- Institutionalize a process-oriented servicing culture focused on accuracy, responsiveness, compliance, and customer empathy.

Key Performance Indicators

- Broker and corporate client satisfaction score.
- Claims query and escalation resolution turnaround time.
- Endorsement processing TAT and accuracy.
- Reduction in repeat escalations and aged open cases.
- Timeliness and quality of servicing MIS and governance reporting.
- Adherence to internal service standards, regulatory requirements, and audit expectations.
- Team productivity, quality scores, and training completion.

Required Experience

- 7-12 years of experience in health insurance, general insurance, TPA, insurance broking, group operations, claims servicing, or corporate client servicing.
- Strong experience in group health insurance servicing, preferably with exposure to employer-employee policies, broker-led accounts, claims escalations, and endorsements.
- Proven experience in managing large corporate clients, brokers, internal operations teams, and cross-functional service delivery.
- Prior leadership experience in servicing operations, claims support, group operations, or customer experience is essential.

📌 Servicing Lead Group Health Business (Bengaluru)
🏢 Prudential Technology And Services
📍 Bengaluru