State Managers|Madhya Pradesh

Key Responsibilities:

• Oversee and manage health claim operations (cashless, reimbursement, and PA claims) across the assigned state.
• Ensure adherence to TATs, quality standards, and claim handling guidelines.
• Supervise, train, and support a team of field investigators, medical reviewers, and coordinators.
• Monitor daily case allocation, field visit performance, and reporting accuracy.
• Ensure timely submission of investigation reports and communication with insurance company representatives.
• Liaise with hospital authorities, TPAs, and clients to resolve claim-related issues.
• Track performance metrics and prepare weekly/monthly MIS reports.
• Identify process gaps and implement corrective actions to improve operational efficiency.
• Ensure compliance with company policies, data security norms, and regulatory guidelines.
• Support business expansion initiatives and coordinate with the Business Development and Quality teams.

Required Qualifications & Skills:

• Education: Graduate / Postgraduate Health Insurance, TPA or related field.
• Experience: Minimum 5–8 years of experience in health insurance claims / investigation / hospital operations, with at least 2–3 years in a supervisory or managerial role.
• Skills:
• Strong understanding of health insurance claim processes and documentation.
• Excellent leadership, communication, and stakeholder management skills.
• Proficiency in MS Office and data reporting tools.
• Problem-solving ability and decision-making skills under tight deadlines

Job Types: Full-time, Permanent

Pay: ₹35,000.00 - ₹60,000.00 per month

Work Location: In person