Head - Travel Insurance Claims

Tripjack; Mumbai; On-site; INR 900,000 - 1,300,000; Full time

Job summary

A leading travel services provider located in Mumbai is seeking an experienced individual to lead their Claims Support team. The ideal candidate will manage the entire claims lifecycle, ensuring quality and compliance while driving continuous process improvements. They will act as an escalation point for team members and collaborate closely with insurance partners to resolve issues efficiently. Strong analytical and communication skills are essential for this role as you work towards enhancing team performance and customer satisfaction.

Qualifications

• Proven experience in team management and claims operations.
• Strong analytical skills for reporting and process improvement.
• Excellent communication skills with stakeholders and customers.

Responsibilities

• Lead and manage the Claims Support team for consistent performance.
• Own end-to-end claim lifecycle governance.
• Serve as primary escalation interface with TPAs and insurance companies.
• Review and publish MIS on claim metrics and compliance.
• Drive continuous process improvements for claims efficiency.
• Own end-to-end claim lifecycle governance across the team, from intimation, documentation, processing, approval/rejection, and closure.
• Ensure all claims are registered accurately with insurers and TPAs as per defined SLAs.
• Review documentation quality and ensure compliance with insurer‑specific requirements.
• Proactively track aging claims and drive follow‑ups to prevent delays.
• Handle high‑value, critical, or escalated claims directly when required.
• Serve as the primary escalation interface with TPAs and insurance companies for unresolved or delayed claims.
• Maintain strong working relationships with insurer and TPA teams to improve turnaround and issue resolution.
• Coordinate with internal sales, operations, and relationship teams to ensure alignment and timely communication.
• Ensure timely and accurate communication to travel agents/customers in case of exceptions or delays.
• Review and publish daily/weekly/monthly MIS on claim volumes, TAT, pendency, rejection trends, and escalations.
• Ensure accurate documentation and record maintenance to support audits and compliance requirements.
• Analyze data to identify recurring issues, bottlenecks, and insurer/TPA‑related challenges.
• Drive continuous process improvements to enhance efficiency, reduce claim TATs, and minimize errors.
• Implement standard operating procedures (SOPs), checklists, and quality benchmarks for the team.
• Collaborate with leadership to implement automation or system enhancements where applicable.
• Ensure adherence to regulatory, insurer, and internal compliance standards.

Job description

Team & People Management

• Lead, coach, and manage the Claims Support team to ensure consistent performance and service quality.
• Allocate claims effectively across the team and ensure optimal workload distribution.
• Monitor individual and team KPIs such as TAT, accuracy, closure rate, and customer satisfaction.
• Conduct regular performance reviews, feedback sessions, and training interventions.
• Act as the first escalation point for team members on complex or sensitive claims.

Claims Operations

• Own end-to-end claim lifecycle governance across the team, from intimation, documentation, processing, approval/rejection, and closure.
• Ensure all claims are registered accurately with insurance companies and TPAs as per defined SLAs.
• Review documentation quality and ensure compliance with insurer‑specific requirements.
• Proactively track aging claims and drive follow‑ups to prevent delays.
• Handle high‑value, critical, or escalated claims directly when required.

Stakeholder & Escalation Management

• Serve as the primary escalation interface with TPAs and insurance companies for unresolved or delayed claims.
• Maintain strong working relationships with insurer and TPA teams to improve turnaround and issue resolution.
• Coordinate with internal sales, operations, and relationship teams to ensure alignment and timely communication.
• Ensure timely and accurate communication to travel agents/customers in case of exceptions or delays.

MIS, Reporting & Compliance

• Review and publish daily/weekly/monthly MIS on claim volumes, TAT, pendency, rejection trends, and escalations.
• Ensure accurate documentation and record maintenance to support audits and compliance requirements.
• Analyze data to identify recurring issues, bottlenecks, and insurer/TPA‑related challenges.

Process Improvement

• Drive continuous process improvements to enhance efficiency, reduce claim TATs, and minimize errors.
• Implement standard operating procedures (SOPs), checklists, and quality benchmarks for the team.
• Collaborate with leadership to implement automation or system enhancements where applicable.
• Ensure adherence to regulatory, insurer, and internal compliance standards.