Health Insurance Operations Executive / Specialist

Finxecute Solutions; Thane; On-site; INR 500,000 - 800,000; Full time

Job summary

A leading health insurance company in Maharashtra is seeking a Health Insurance Operations Executive to manage policy lifecycle processes, coordinate claims, and maintain accurate data records. The ideal candidate will have a degree, relevant experience in health insurance operations, and strong Excel skills. Join a team focused on compliance and process improvement.

Qualifications

• 3 to 6 years of experience in backend health insurance operations.
• Good understanding of health insurance policy and claims processes.
• Familiarity with IRDAI regulations is an added advantage.

Responsibilities

• Handle end-to-end processing of policy issuance, endorsements, cancellations, and renewals.
• Facilitate smooth coordination with TPAs for claims data processing.
• Prepare MIS reports, trackers, and dashboards related to policy and claims operations.

Skills

Attention to detail

Process orientation

MS Excel

Time management

Education

Bachelor’s degree

Insurance certifications

Tools

Operational systems

Job description

Thousands of jobs in the computer, engineering andtechnology sectors are waiting for you.

Full time

Health Insurance Operations Executive / Specialist

workflows and regulations, with a focus on accuracy and timeliness.

Key Responsibilities:

• Policy Lifecycle Management:
  • Handle end-to-end processing of policy issuance, endorsements, cancellations, and renewals
  • Validate policy data and documentation for accuracy and compliance
  • Coordinate internally with underwriting and sales support teams for policy inputs
• Claims Coordination:
  • Facilitate smooth coordination with TPAs for claims data processing
  • Track claim status and ensure all backend documentation is in place
  • Update claim-related information in internal systems and elevate delays if required
• Data Management and Reporting:
  • Maintain accurate records in internal systems and trackers
  • Prepare MIS reports, trackers, and dashboards related to policy and claims operations
  • Assist in data audits, reconciliations, and regulatory reporting
• Compliance and Quality Checks:
  • Ensure all activities comply with IRDAI guidelines and internal SOPs
  • Perform regular quality checks on data and documentation
  • Support periodic internal and external audits
• Process Improvement Support:
  • Identify gaps or inefficiencies in operational workflows
  • Provide suggestions to streamline processes and reduce turnaround times
  • Participate in UAT and implementation of new tools/systems when required

Candidate Profile:

• Graduate in any discipline (Bachelor’s degree required; Insurance certifications preferred)
• 3 to 6 years of experience in backend health insurance operations (TPA, insurer, broker)
• Good understanding of health insurance policy and claims processes
• Proficient in MS Excel (pivot tables, VLOOKUP, basic formulas) and operational systems
• Strong attention to detail and process orientation
• Excellent organizational and time management skills
• Familiarity with IRDAI regulations is an added advantage