PHI - Manager/Assistant Manager – Travel Insurance Operations & Claims Management

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

At Prudential Health India (PHI), we are on a mission to make Indians healthier, while bridging the health protection gap. This is a Zero to One team undertaking a greenfield health insurance deployment in India committed to building journeys that will truly empathize with the customer and offer a differentiated, bespoke experience.

To partner us in this mission, we are looking for a talented…

Manager/Assistant Manager – Travel Insurance Operations & Claims Management

As a Manager / Assistant Manager - Travel Insurance Process, your typical week might include the following:   

• Collaborate in designing, developing and implementing end-to-end insurance customer journeys to manage a customer-centric Travel Insurance experience.  
• Collaborate in creating robust frameworks, business processes, and systems factoring in product coverages, features, claims-related information, and fraud engines that actively share information with products, pricing underwriting and sourcing channels
• Collaborate to develop and evolve detailed standard operating procedures for comprehensive and seamless functioning of onboarding, issuance, servicing & claims management & adjudication 

• Collaborate with functions including but not limited to Technology, Product & Actuarial, Marketing, Onboarding, Underwriting, Issuance, Claims, Compliance, Risk Management, and Finance; represent experience Function in cross-functional implementations

• Collaborate with Sales and Strategy for various partnerships and process setup.
• Review, examine, and calculate the eligible amount based on policy eligibility, examine claim forms and records to determine coverage and ensure claims of valid settlements are processed according to the company practice and procedures. 
• Process & approve non-medical claims with sharp FWA and Loss minimization approaches. 
• Collaborate in setting up Third party Administrator assistance services for international travel claims.
• Coordinate with Travel Insurance assistance TPA for cashless hospitalization for international travel policy holders and Reimbursement cases at scale.
• Collaborate with medical team for creating guidance for processing teams for international travel medical hospitalization & OPD claims
• Collaborate to manage vendors/ partners and Travel Insurance assistance TPAs to ensure a delightful customer experience while ensuring process rigor and SLAs
• Lead, manage, and develop your team, establish clear responsibilities for all team members build a strong culture of accountability and performance, manage training & development of team members; enable teams with coaching & structured skills to scale with business & perform effectively

You could be the right candidate if you…  

• Have 5-6 years of experience in Travel Insurance operations and claims management with at least 2-3 years’ experience in lead/ equivalent role. 
• Expert knowledge of Travel Insurance product features, process, regulatory and compliance requirements and implementation and management of comprehensive Travel insurance operations & claims management process. 
• Aware of International Travel Insurance Medical Claims, terms & systems
• Understand the International Travel Insurance TPA ecosystem and have experience of managing TPA model
• Have startup experience or setting up a team from scratch (Preferred but not mandatory) 
• Can make informed decisions, swiftly and are adept at creative problem solving; have good judgment and analytical skills
• Have excellent verbal and written communication skills and strong negotiation skills. 
• Thrive in environments that celebrate co-creation and collaboration.
• Have high resilience – can manage yourself, your teams and your peers when faced with ambiguity or failure 

This could be the gig for you if you…  

• Are passionate about consumer behavior and culture; enjoy spending time with customers to understand what they want. Have an attentive ear to listen to new ideas.
• Join hands with other colleagues to solve for the customer.
• Like to work in a culture where everyone can see what others are doing.
• Take help from others when stuck and encourage others when there are setbacks.
• Take full responsibility for your team’s contribution output while thinking wing-to-wing across the organization.
• Have strong clinical knowledge and clinical decision-making skills
• Have built best-in-class processes from scratch
• Are passionate about leveraging digital tools to transform customer experience

Location: Mumbai

Title: Manager / Assistant Manager – Travel Insurance Operations & Claims management  

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.