Job
Description
Position: SM/AVP – SMART Claims
Location: Noida
Job Type-Hybrid-3 days
Reporting: Head of Business Transformation/ Operations Unit - India
Position Overview: Lead the establishment and operations of a strategic Claims Support Center in Noida, driving 24/7 excellence in claims processing support for global BI/PD adjusters. This is a leadership role requiring a seasoned professional to build, mentor, and scale a high-performance team from ground up.
Key Responsibilities
Strategic Leadership:
Establish and operationalize the Claims Support Center within 90 days
Develop comprehensive operational procedures, quality standards, and performance metrics
Design and implement 24/7 shift operations including night shift (6 PM - 3 AM IST)
Create scalable processes to support global adjuster teams across multiple time zones
Claims Process & Workflow Management
Ability to design, document, and continuously improve end-to-end claims workflows (FNOL to closure) to improve speed, quality, and cost.
Ability to define standard operating procedures (SOPs) and ensure adjusters and operations teams adhere to them.
Ability to monitor claims inventory and workload distribution, and recommend actions to balance capacity and meet SLAs.
Ability to identify bottlenecks or failure points in claims handling and propose practical process fixes.
Core Analytical & Problem-Solving Skills
Strong ability to analyze claim patterns, exceptions, and outliers to detect potential fraud, leakage, or process gaps.
Ability to use data from multiple systems (claims platform, CRM, document management, billing) to form a holistic view of the claim.
Ability to prioritize and decide quickly in ambiguous situations, while staying aligned with guidelines and risk appetite.
Quality, Compliance & Risk Management
Ability to ensure regulatory and internal compliance (documentation standards, privacy, fair claims handling, local regulations).
Ability to identify claim leakage (overpayments, missed recoveries, unnecessary expenses) and recommend preventative controls.
Ability to create/review checklists and guidelines to standardize proper documentation, reserves, and settlement practices.
. Adjuster Support & Coaching
Ability to act as a subject matter expert and first point of escalation for adjusters on complex coverage or process questions.
Ability to coach and mentor TEAM on best practices, documentation quality, investigation standards, and negotiation strategies.
Ability to conduct training sessions on new products, processes, tools, and regulatory changes impacting claims.
Ability to communicate complex concepts in simple language, tailored to new joiners as well as experienced adjusters.
Operational Excellence & Team Management
Build end-to-end claims support activities including documentation, investigation support, and stakeholder communication
Ensure compliance with regulatory requirements and company policies
Manage real-time support delivery to field adjusters
Drive process improvements and automation initiatives
Stakeholder Management
Collaborate closely with BI/PD adjusters to understand support requirements
Coordinate with IT teams for technology integration and system optimization
Report to senior management on operational metrics and strategic initiatives
Ability to collaborate with cross-functional teams (Underwriting, Legal, SIU/Fraud, IT, Operations, Finance) to resolve claim issues.
Ability to represent claims in projects and workshops, ensuring adjuster needs and customer impacts are clearly articulated.
Ability to influence without authority, driving adoption of new processes, tools, and behaviors across the claims team
Required Qualifications
Experience & Education
Minimum 14+ years in claims management with proven leadership experience
Bachelor's/Masters degree in Business, Finance, Insurance, or related field
Essential: Hands-on experience with BI (Bodily Injury) and PD (Property Damage) claims
please share your resume at shobhana@futuristicuwltd.com
