Claims Head — Health Insurance

Location: Mumbai (Goregaon West)

Experience: Required 5+ years in health insurance claims

Department: Claims & Customer Experience

Employment Type: Full-time

About Us

We are a health-focused platform committed to simplifying the insurance and healthcare experience for customers. We aim to provide customers with transparent, responsive, and hassle-free support throughout their health insurance journey — especially during claims.

About the Role

As Claims Head, you will take end-to-end ownership of the health insurance claims process — from intimation through to final settlement and closure. You'll manage relationships with insurance companies, TPAs, and hospitals, lead a claims team, and act as the primary escalation point for complex or high-value cases. This is a high-impact role at the intersection of operations, relationship management, and customer experience, directly shaping how customers experience one of the most stressful moments of their healthcare journey.

Key Responsibilities

End-to-End Claims Management





• Own the complete health insurance claims lifecycle across cashless and reimbursement claims.

• Monitor claims from intimation through documentation, assessment, approval/rejection, settlement, and closure.

• Ensure claims are processed within applicable turnaround times (TATs).

• Review pending, delayed, rejected, and disputed claims, and drive corrective action.

• Develop SOPs and processes for productive, consistent claims handling.

Claims Kavach (Proactive Customer Support)

• Lead our proactive claims-assistance initiative, offering proactive support during hospitalization and claims.

• Help customers understand the claims process, documentation needs, and policy coverage.

• Guide customers through cashless approvals, queries, deductions, rejections, and settlements.

• Identify potential claim issues early and intervene before they escalate.

• Partner with the IT & Product teams on automation and bui

📌 Claims Head – Health Insurance (Mumbai)
🏢 Consultbae India
📍 Mumbai