Senior Manager Health Insurance Claims
- Pazcare
- 3 - 5 years
- Bengaluru
- 5 months ago
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Job Description
- Job Title: Sr Manager Health Insurance Claims
- Location: Bangalore (Hybrid)
- Company: Pazcare
- Type: Full-time
About Pazcare
Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences.
Role Overview
As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated.
Key Responsibilities
- Ensure all reimbursement and cashless claims are processed within the committed TAT across clients.
- Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps.
- Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients.
- Collaborate closely with the customer success and insurance teams to address claim escalations proactively.
- Drive continuous process improvement in claims handling and communication workflows.
- Maintain internal dashboards and reports to track SLAs and spot trends.
Requirements
- 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred).
- Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines.
- Assertive communicator with negotiation skills to handle TPAs and insurers.
- Analytical mindset with ability to identify patterns in delays or rejections.
- Empathy for the end user the employee or HR dealing with a health issue.
Why Join Pazcare?
- Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits.
- Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale.
- Be part of a culture that values transparency, speed, and customer-first thinking.
Job Classification
Industry: InsuranceFunctional Area / Department: Customer Success, Service & OperationsRole Category: OperationsRole: Operations - OtherEmployement Type: Full timeContact Details:
Company: PazcareLocation(s): Bengaluru
Keyskills: TPA Claims Adjudication Health Claims Health Insurance Claims Processing Claims Management Claims Handling Client Management Healthcare Operations Client Servicing Data Analysis Claim Settlement Stakeholder Management
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