Assistant Manager Operations - Claims

Principal Financial Group; Maharashtra; On-site; INR 1,500,000 - 2,100,000; Full time

Job summary

Principal Financial Group in Pune, Maharashtra, India, invites an experienced Assistant Manager Operations - Claims to lead the dental claims function. The role focuses on compliance, accurate claim decisions, and coordinating benefits across health, life, and disability claims.

You will design training, mentor teams, and drive performance. Shift timings are 1:30 PM to 10:30 PM (training 5:30 PM to 2:30 PM for 3 months).

Qualifications

• Bachelor of Dental Surgery (BDS), Bachelor of Ayurvedic Medicine and Surgery (BAMS), or Bachelor of Homeopathic Medicine and Surgery (BHMS), or equivalent experience.
• Minimum of 10 years' experience in back office operations within insurance, preferably with domestic insurers or abroad.
• Experience in claims processing of health insurance, life, and disability claims is preferred.
• Proficient in MS Office with excellent written and verbal communication skills.

Responsibilities

• Manage the dental claims function in strict accordance with policy, state, and federal laws and regulations.
• Analyze claim details and apply your knowledge of claims procedures, product development, contract provisions, and regulations to ensure accurate and timely claim decisions.
• Understand plan provisions, determine eligibility, verify data input, identify accurate benefit levels, coordinate benefits, and make necessary corrections.
• Build, develop, coordinate, and conduct training programs for individuals and teams, both large and small scale.
• Manage training and mentoring, ensuring detailed reporting of team and individual training progress to superiors.
• Communicate company strategy, goals, and deadlines to team members, motivate them, and assess their performance.
• Facilitate communication of concerns and policies between management and team members.
• Coordinate effective collaborator management, new migrations, customer happiness, and operational risk management.
• Foster a culture of innovation and process simplification.

Skills

MS Office

Verbal & written communication

Education

BDS

BAMS

BHMS

Job description

About the Role

Join our dynamic team as an Assistant Manager Operations - Claims in Pune, Maharashtra, India. This is an outstanding opportunity to bring your expertise to a company that values innovation, collaboration, and flawless execution. If you are ambitious and looking for a role where you can truly make a difference, this is the perfect fit!

Responsibilities

• Manage the dental claims function in strict accordance with policy, state, and federal laws and regulations.
• Analyze claim details and apply your knowledge of claims procedures, product development, contract provisions, and regulations to ensure accurate and timely claim decisions.
• Understand plan provisions, determine eligibility, verify data input, identify accurate benefit levels, coordinate benefits, and make necessary corrections.
• Build, develop, coordinate, and conduct training programs for individuals and teams, both large and small scale.
• Manage training and mentoring, ensuring detailed reporting of team and individual training progress to superiors.
• Communicate company strategy, goals, and deadlines to team members, motivate them, and assess their performance.
• Facilitate communication of concerns and policies between management and team members.
• Coordinate effective collaborator management, new migrations, customer happiness, and operational risk management.
• Foster a culture of innovation and process simplification.

Qualifications

• Bachelor of Dental Surgery (BDS), Bachelor of Ayurvedic Medicine and Surgery (BAMS), or Bachelor of Homeopathic Medicine and Surgery (BHMS), or equivalent experience.
• Minimum of 10 years' experience in back office operations within insurance, preferably with domestic insurers or abroad.
• Experience in claims processing of health insurance, life, and disability claims is preferred.
• Proficient in MS Office with excellent written and verbal communication skills.

Shift Timings – 1.30 to 10.30PM (During Training 5.30 - 2.30PM which is for 3 months)

Additional Information

At Principal Financial Group, we believe in providing a world-class work environment that fosters growth and success. Our team members are our greatest asset, and we are committed to their professional development. You will have the opportunity to work with a team of dedicated professionals and contribute to innovative projects. We value diversity, inclusion, and the outstanding perspectives each team member brings. Join us and be a part of a company where your ideas and contributions are recognized and valued!