Head of Claims

The role is with a leading General Insurance company.About the Role The organization is seeking a seasoned Head of Claims to lead its Health Insurance Claims function. The role focuses on driving operational excellence, regulatory compliance, and digital transformation across the claims lifecycle.Responsibilities Lead and enhance claims systems, rule engines, and automated workflows. Oversee end-to-end claims operations—from intimation to settlement. Guide resolution of complex and high-value claims. Drive technology adoption, process automation, and efficiency improvements. Ensure full compliance with IRDAI regulations and audit requirements. Monitor KPIs, claims performance, and regulatory reporting (IRDAI/IIB). Collaborate with underwriting, legal, product, IT, TPAs, and hospitals. Manage escalations and ensure superior customer experience.Qualifications 10+ years of health insurance claims experience, with strong leadership exposure.Required Skills Expertise in medical coding (ICD-10, CPT), claims assessment, and billing processes. Proven ability to work with claims management systems, automation tools, OCR, RPA, workflow engines, or AI/ML-led solutions. Strong analytical, decision-making, and stakeholder management skills.If you are interested for the same then connect with saloni@ -/in/salonikamdar

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