claims manager

Fletcher Piccolo Associates

<div>
 <p>
  We are currently hiring a Claims Manager to join a Tier 1 Contractor based in Riyadh, KSA, specialising in large-scale infrastructure projects across the Kingdom.
 </p>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   The Role
  </strong>
 </p>
 <p>
  The Claims Manager will be responsible for overseeing, preparing, and negotiating claims and variations, ensuring the contractor&rsquo;s contractual and commercial rights are protected, while minimising risks and resolving disputes effectively.
 </p>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Key Responsibilities
  </strong>
 </p>
 <ul>
  <li>
   Manage and lead the preparation, submission, and negotiation of contractual claims to protect the company&rsquo;s commercial interests.
  </li>
  <li>
   Ensure compliance with contract terms and legal requirements, providing expert advice to project teams &amp; senior management.
  </li>
  <li>
   Oversee claims documentation and evidence gathering, liaising with project controls, planning, legal, and site teams.
  </li>
 </ul>
 <p>
  <strong>
   Requirements
  </strong>
 </p>
 <ul>
  <li>
   Minimum 15-20 years of relevant experience within the construction industry, with at least 5 years focused on claims management for large-scale infrastructure projects.
  </li>
  <li>
   Proven experience within the GCC, working for reputable main contractors.
  </li>
  <li>
   Strong contractual knowledge of FIDIC and other international standard forms of contracts.
  </li>
  <li>
   Strong communication and leadership abilities, capable of leading successful teams, and communicating with multiple project teams.
  </li>
 </ul>
 <p>
 </p>
</div>


Claims Manager

Fletcher Piccolo Associates (FPA)

The Role
<br>We are currently hiring a Claims Manager to join a Tier 1 Contractor based in Riyadh, KSA, specialising in large-scale infrastructure projects across the Kingdom. Key Responsibilities: • Manage and lead the preparation, submission, and negotiation of contractual claims to protect the company's commercial interests. • Ensure compliance with contract terms and legal requirements, providing expert advice to project teams & senior management. • Oversee claims documentation and evidence gathering, liaising with project controls, planning, legal, and site teams.
<br><br>
Requirements
<br><ul>
<li>Minimum 15-20 years of relevant experience within the construction industry, with at least 5 years focused on claims management for large-scale infrastructure projects. • Proven experience within the GCC, working for reputable main contractors. • Strong contractual knowledge of FIDIC and other international standard forms of contracts. • Strong communication and leadership abilities, capable of leading successful teams, and communicating with multiple project teams.</li>
</ul>
About the company
<br>Founded by Aaron Fletcher and Tony Piccolo, FPA is a prominent recruitment and HR consulting firm operating in the Middle East and the UK. With an impressive professional background of over 22 years, both founders have established themselves as reliable partners for top-tier talent acquisition in the industry. Our firm's skilled team provides a wide range of specialized services, including executive search, specialist recruitment, and industry salary benchmarking, tailored to meet the unique needs of our clients. We take a comprehensive approach to ensure that we find the right talent to drive businesses forward. At FPA, we are committed to excellence and leverage our industry expertise to navigate the competitive landscapes of the Construction and Real Estate markets. This dedication to our clients makes us the preferred partner for businesses seeking success in these industries.

MedNet Egypt L.L.C

<div>
 <p>
  <strong>
   MedNet Egypt
  </strong>
  is one of the leading managed care service organisations that cater to healthcare needs. We are looking for a skilled
  <strong>
   Assistant Manager - Claims
  </strong>
  who is responsible for Planning and managing the data entry and claims processing operations of MedNet UAE&rsquo;s Top Insurer in order to ensure the delivery of high quality claims handling services to customers within the defined turnaround times (TAT) in accordance with established policies and corporate guidelines in order to support the achievement of revenue targets and overall business objectives.
 </p>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Your Job:
  </strong>
 </p>
 <ul>
  <li>
   Manage claims processing operations for provider network claims, direct reimbursements, and re-submissions, ensuring efficiency and compliance with turnaround times (TAT).
  </li>
  <li>
   Oversee claims settlement as per financial authority levels and ensure proper reserve management.
  </li>
  <li>
   Ensure quality assurance through spot-checking and audits, ensuring claims are processed accurately and efficiently.
  </li>
  <li>
   Monitor technological system performance and coordinate with the IT department for system enhancements to improve operational efficiency.
  </li>
  <li>
   Lead and develop teams by setting objectives, providing coaching, and offering continuous training to maintain high performance.
  </li>
  <li>
   Act as an external auditor for high-value claims, ensuring compliance with internal policies before submission to the Hub Manager.
  </li>
  <li>
   Act as an Account Manager for primary insurance companies and groups, ensuring service delivery aligns with SLAs.
  </li>
  <li>
   Drive continuous improvement in claims processes, cost reduction strategies, and workflow optimisation.
  </li>
  <li>
   Ensure compliance with local health insurance laws, MedNet, and Munich Re policies.
  </li>
  <li>
   Supervise claims processing reports to support decision-making and ensure compliance with corporate standards.
  </li>
  <li>
   Coordinate with internal teams and external stakeholders (insurance partners, brokers, providers) for efficient claims handling.
  </li>
  <li>
   Implement process improvements to enhance operational effectiveness and service quality.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Your Profile
  </strong>
 </p>
 <p>
  <br/>
 </p>
 <ul>
  <li>
   Bachelor&rsquo;s degree in Medicine, Pharmacy, or Dentistry.
  </li>
  <li>
   5+ years of experience in medical claims management, with at least 2 years in a supervisory role.
  </li>
  <li>
   Strong knowledge of medical coding and claims processing procedures.
  </li>
  <li>
   Excellent time management and database management skills.
  </li>
  <li>
   Strong leadership and team management capabilities.
  </li>
  <li>
   Problem-solving and analytical thinking to improve claims operations.
  </li>
  <li>
   Customer-focused mindset with strong communication and stakeholder management skills.
  </li>
  <li>
   Ability to handle multiple priorities and work in a fast-paced environment.
  </li>
  <li>
   Proficiency in healthcare regulations and compliance standards
  </li>
 </ul>
 <p>
 </p>
</div>


Assistant Claims Manager

Zurich Insurance

<div><p><b>Join Our Team as a Team Manager &ndash; General Liability at Zurich North America!</b></p><p></p><p><br>
Are you ready to lead a dynamic team and make an impact in the world of commercial general liability claims? Zurich North America is seeking a Team Manager &ndash; General Liability to join our talented Claims team. This is an exciting opportunity to work in one of the following locations: Addison, TX; Schaumburg, IL; Atlanta, GA; Gold River, CA; Maitland, FL; Omaha, NE; Overland Park, KS; or Parsippany, NJ.</p><p></p><p><br>
In this role, you&rsquo;ll take the lead in guiding a team of technical Claims Professionals, driving superior results, and fostering a culture of excellence. Your leadership will be key to ensuring operational efficiency, exceptional customer satisfaction, and the professional growth of your team members.</p><p></p><p><b><br>
Your Key Responsibilities:</b></p><br>
<p></p><ul><li>
Deliver Results: Oversee the management of commercial general liability claims of moderate complexity by providing technical guidance, direction, and performance tracking.</li><li>
Elevate Customer Satisfaction: Build strong relationships with internal and external stakeholders, resolve quality concerns, and ensure high levels of service.</li><li>
Drive Best Practices: Analyze claims trends, recommend process improvements, and uphold compliance with legal and regulatory standards.</li><li>
Lead with Purpose: Manage a high-performing team by recruiting, developing, and retaining top talent, fostering a collaborative and supportive workplace culture.</li><li>
Optimize Operations: Monitor team resources, allocations, and expenditures to manage costs effectively.</li><li>
Inspire Growth: Provide coaching, feedback, and development opportunities to help your team reach their full potential.</li><li>
Collaborate for Success: Partner with other business units to provide claims insights, assist with product development, and engage in customer and broker meetings.</li></ul><p></p><p><b><br>
Basic Qualifications:</b></p><br>
<p></p><ul><li>
Juris Doctor with 5+ years of claims experience<br>
OR</li><li>
Bachelor&rsquo;s Degree with 6+ years of claims experience<br>
OR</li><li>
High School Diploma or Equivalent with 8+ years of claims experience<br>
AND</li><li>
Strong customer service skills.</li><li>
Proficiency in Microsoft Office.</li><li>
Experience collaborating across teams.</li><li>
Knowledge of insurance legal statutes, claims handling, and regulatory environments.</li><li>
Ability to travel up to 20%.</li></ul><p></p><p><b><br>
Preferred Qualifications:</b></p><br>
<p></p><ul><li>
Experience managing commercial general liability claims.</li><li>
Expertise in construction-related claims.</li><li>
Leadership experience in claims or operations.</li><li>
Strong negotiation and analytical skills.</li></ul><p></p><p><br>
At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please click here. Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education.</p><p>
The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $98,300.00 - $161,000.00, with short-term incentive bonus eligibility set at 15%.</p><p></p><p><br>
As an insurance company, Zurich is subject to 18 U.S. Code &sect; 1033.</p><p></p><p><br>
A future with Zurich. What can go right when you apply at Zurich?</p><p></p><p><br>
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500&reg;. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here to learn more.</p><p></p><p><br>
Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.</p><p></p><p><br>
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.</p><p></p><p><br>
Location(s): AM - Parsippany, AM - Addison, AM - Atlanta, AM - Gold River, AM - Maitland, AM - Omaha, AM - Overland Park, AM - Schaumburg<br>
Remote Working: Hybrid<br>
Schedule: Full Time<br>
Employment Sponsorship Offered: No<br>
<br>
Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-HYBRID</p></div><p></p>

Claims Team Manager, General Liability (Construction)

Prudential Plc

<div><div>Prudential&rsquo;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&rsquo;s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.</div><div></div><div>
Prudential (UK) in partnership with HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer.</div><div></div><div>
This joint venture will combine Prudential's global expertise in insurance and financial services with HCL Group&rsquo;s experience in technology and healthcare solutions.</div><div></div><div>
Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India&rsquo;s first World Cup Victory!</div><div></div><div>
Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience.</div><div></div><div>
To partner with us in this mission, we are looking for a talented Manager &ndash; Claims Management to join our Experience team in Mumbai.</div><div></div><div>
Manager - Claims Management</div><div>
As a Manager Claims, your typical week might include the following:</div><div></div><ul><li>
Guiding processing team by providing medical opinion for Health Insurance Claims</li><li>
Ensure claims of valid settlements are made according to the company practice and procedures.</li><li>
Processing and approving medical claims pertaining to Indemnity, Benefit for both Group and Retail, with sharp FWA and Loss minimization approaches.</li><li>
Thorough on the compliance and regulatory requirements and implementation in the claims process.</li><li>
Creating detailed standard operating process for seamless functioning of claims adjudication</li><li>
Case management of potential cases to Network team, maintaining data of referred/saving achieved/impact against cashless outgo.</li><li>
Automation and rule driven decision making with timely update of benefit in TAT / TMS / Transaction</li><li>
Create and reviewing claim simplification guidelines to Improve TAT, Minimize transaction.</li><li>
Manage floor &ndash; people and SLA (TAT) &ndash; create roster, manage adequate manpower on daily basis, especially on weekends and public holidays.</li><li>
Audit of TPA processed claims and also Inhouse processed claims.</li><li>
Medical decisioning and guidance to the team</li><li>
Analytics and Dashboard &ndash; Dashboard preparation to Manage TAT, Cost vector (ACS, Pay-out ratio), Loss ratio, CS:RI ratio and regional distribution.</li><li>
Support to Group UW team for providing claims analytic input like Specific trend related to FWA, Frequency, Loss ratio, utilization of particular benefit.</li><li>
Regulatory compliances &ndash; Claim processing guideline as per compliance and timely implementation of any New Circular.</li><li>
Litigation cases &ndash; Claim related to Input and evidence in SCN (Self-containment note) to make our stand stronger in Ombudsman/any other legal forum.</li><li>
Train TPA teams &ndash; Timely Training of TPA for new benefit, process change, Understanding and claim Philosophy as per PHI standard.</li><li>
Benefit claims &ndash; Well versed with processing of Benefit claims, Creating SOP, Pay-out framework to Nominee/Legal heir.</li><li>
Collaborate with FWA Manager to provide inputs from agencies for efficient Fraud restriction and necessary checks and balances in system.</li><li>
Re-UW opinion for non-disclosure cases &ndash; Training to Team for indicated cases for Re-UW referral, tracking and corrective action basis UW decision.</li><li>
Extend support to the sales/distribution &ndash; Separate prioritization que for Green channel, Specific Agent, Broker.</li><li>
Set up and create robust governance to manage TPA process with great efficiency.</li><li>
Proficient with medical terms &amp; systems (including ICD/CPT/PCS codes).</li><li>
Collaborate with Underwriting, Actuarial, Finance and other stakeholders to ensure knowledge sharing on market trends, legal changes, and loss developments.</li></ul><div></div><div>
You could be the right candidate if you&hellip;</div><ul><li>Are a doctor by training (MBBS preferred /BAMS/BHMS/BDS)</li><li>Have 07-10 years&rsquo; experience of health Insurance claims management with at least 2-3 years&rsquo; experience in Manager role.</li><li>Understands the TPA ecosystem and has experience of managing TPA model (Preferred)</li><li>Have startup experience or setting up a team from scratch (Preferred but not mandatory)</li><li>Should be a decisive &amp; creative individual.</li><li>Should be able to make quick decisions and have good judgment and analytical skills</li><li>Have an excellent verbal and written communication skills and strong negotiation skills.</li><li>Always open to embracing change and be able to manage it</li><li>Managed team with people from Medical and Non-Medical background</li></ul><div></div><div>
This could be the gig for you if you&hellip;</div><ul><li>Are passionate about consumer behaviour and culture; enjoy spending time with customers to understand what they really want. Have an attentive ear listen to new ideas.</li><li>Like to work in a culture where everyone can see what others are doing</li><li>Take help from others when stuck and encourage others when there are setbacks</li><li>Take full responsibility for your own output while thinking wing to wing across the organization; to solve for the customer</li><li>Have strong clinical knowledge and clinical decision-making skills</li><li>Have built best in class processes from a scratch.</li><li>Are passionate about leveraging digital tools to transform customer experience What can make you extra special.</li></ul><div></div><div>
What can make you extra special</div><ul><li>It&rsquo;s a great if you have already read books like Blue Ocean strategy &amp; Zero to One. Before you saw them mentioned here.</li><li>You have real stories to tell about how your team and you challenged convention and took the path less travelled.</li><li>We are keen to listen to your story; doesn&rsquo;t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly.</li></ul><div></div><div>
Location: Mumbai</div><div></div><div><br>
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.</div></div><div></div>

PHI - Manager- Claims Management

EXL Service

<div><p>Job Description: Insurance supports the Insurance Manager in overseeing the company&rsquo;s insurance operations, ensuring proper risk management, policy administration, and claims processing. The role involves coordinating with insurance providers, managing compliance with regulatory requirements, and contributing to the development of insurance strategies to minimize risk exposure.</p></div>
<br><p></p><div><p>Responsibilities: Assist in managing the day-to-day insurance operations, including policy issuance, renewals, and claims processing.
</p><p>Liaise with insurance companies, brokers, and other stakeholders to negotiate terms and ensure best coverage at competitive rates.
</p><p>Review and analyze insurance policies to ensure compliance with company and regulatory requirements.
</p><p>Support the Insurance Manager in risk assessment and mitigation strategies.
</p><p>Handle employee insurance queries and provide guidance on coverage details.
</p><p>Maintain accurate records and documentation related to insurance policies and claims.
</p><p>Prepare periodic reports on insurance activities, claims status, and risk exposures for management.
</p><p>Assist in conducting internal audits and compliance checks on insurance processes.
</p><p>Keep abreast of industry trends, regulations, and market developments to advise management accordingly.
</p><p>Train and mentor junior team members as needed.</p></div>
<br><div><p>Qualifications: Bachelor Degree in relevant field with 4 - 6 years of relevant experience</p></div>

Lead Assistant Manager-Voice-Claims

Tata Aia Life

<div><div><div><div><div>Role Summary</div>
</div><div><p>
Closing Ratio/Meeting all KPI of team member&amp; Self</p>
<ul><li>Negotiate with dealers</li>
<li>Large Value Claims handling</li>
<li>Avoid cost wastage
</li><li>Workshops</li>
<li>Regular training of claims policies</li>
<li>Faster settlements</li>
<li>Settlement Ratio-97%</li>
<li>Investment Ratio-3%</li></ul><br>
<p>
</p></div></div><div><div><div>Key Accountabilities/ Responsibilities</div>
</div></div><div></div><div><div><div>Stakeholder interfaces</div>
</div></div><div></div><div><div><div>Experience</div>
</div><div><div>
3-5 years of experience in Motor Claims &amp; Body paint Workshop.</div></div></div><div><div><div>
Education</div>
</div><div><ul><li>Preferably Diploma in Automobile,
</li><li>Graduate from MechanicalEngineer</li>
<li>Graduate from Any discipline with prior experience in Claims</li></ul></div></div></div></div>

Manager - Auto Claims

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