We are looking for an experienced and customer-focused Assistant Manager – Health Claims ( Employee benefits) to manage and oversee health insurance claims operations in an insurance broking environment. The role will be responsible for ensuring timely and productive claim resolution, coordinating with insurers, TPAs, hospitals, clients and employees, and maintaining high standards of service and compliance.

Key Responsibilities

Health Claims Management
Manage the end-to-end health insurance claims process, including cashless and reimbursement claims.
Review and monitor claims to ensure timely processing and resolution.
Coordinate with insurance companies, TPAs and hospitals for claim approvals, queries, documentation and settlements.
Handle escalated and complex claims and ensure appropriate resolution within defined timelines.
Monitor pending, rejected, repudiated and disputed claims and drive them towards closure.
Review claim-related documents and identify discrepancies, exclusions, policy limitations and other relevant issues.
Assist clients and employees in understanding claim procedures, policy perks and documentation requirements.
Ensure claims are handled in accordance with policy terms,



insurer guidelines and applicable regulatory requirements.

Client & Relationship Management
Act as a key point of contact for corporate clients on health claims-related matters.
Build strong relationships with clients, insurers, TPAs and healthcare providers.
Understand client requirements and provide timely solutions to claims-related concerns.
Conduct regular claims reviews and provide clients with updates on claim trends, pending cases and key issues.
Handle client escalations professionally and ensure timely closure.

Key Performance Indicators (KPIs)
Claims turnaround time and SLA adherence
Pending and ageing claims
Claim resolution and closure rate
Escalation resolution time
Client satisfaction and service quality
Team productivity and performance
Accuracy of claims processing and MIS
Effective coordination with insurers and TPAs
Reduction in unresolved and disputed claims

Pay: ₹300,000.00 - ₹600,000.00 per year

Perks
Health insurance
Life insurance
Paid sick time
Paid time off
Provident Fund

Work Location: In person

📌 Asst Manager Employee Benefits Claims Chennai
🏢 Sriyah Insurance Brokers
📍 Chennai