Job Description

The Assistant Manager - Operations (Health Insurance) will be responsible for overseeing day-to-day operational activities related to health insurance processes including cashless, reimbursement, claim assessment, and coordination with internal and external stakeholders. The role requires strong process management, team leadership, and client servicing skills to ensure smooth functioning and adherence to SLAs and quality standards.

Key Responsibilities:

1. Operations Management:

Supervise and monitor daily operational activities related to claims processing, pre-authorization, and reimbursements. Ensure timely completion of tasks within defined TAT and quality benchmarks. Review and streamline operational workflows for improved efficiency. Manage escalations and provide resolutions within timelines.

2. Team Supervision:

Lead, train, and motivate the operations team to achieve performance goals. Conduct regular team meetings, performance reviews, and provide feedback. Ensure adequate staffing and resource allocation for all shifts.

3. Client & Stakeholder Coordination:

Act as a key point of contact between internal teams and insurance companies/TPAs/hospitals. Maintain strong relationships with clients to ensure service satisfaction. Address client queries and operational concerns promptly.

4. Quality & Compliance:

Ensure adherence to company policies, standard operating procedures (SOPs), and regulatory guidelines. Monitor data accuracy and maintain confidentiality of customer information. Identify process gaps and implement corrective actions.

5. Reporting & Analysis:

Prepare and present daily/weekly/monthly MIS reports on operational performance. Track KPIs and recommend process improvements. Support audits and internal reviews as required.

Qualifications & Experience:

Bachelor's or Master's degree in Healthcare Administration, Insurance Management, Business Administration, or related field. Minimum 2-4 years of experience in health insurance operations (cashless/reimbursement/claims handling). Prior team handling experience is preferred.

Skills Required:

Strong knowledge of health insurance processes and TPA operations. Excellent communication and coordination skills. Proficiency in MS Office (Excel, Word, PowerPoint). Strong analytical, problem-solving, and decision-making abilities. Ability to work under pressure and meet deadlines.

Key Attributes:

Process-oriented and detail-focused. Strong leadership and people management skills. Customer-centric approach with a focus on service quality. Adaptable and proactive in a dynamic work environment.
Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹30,000.00 per month

Work Location: In person