Verified today
Business Solution Specialist - Claims
About the role
Prudential Health India (PHI) seeks a Business Solution Specialist – Claims to lead the design, implementation, and continuous improvement of a customer‑centric Claims Management function. The role involves collaborating with cross‑functional teams (Technology, Product, Actuarial, Compliance, Risk, Finance) to co‑create new products, processes, and workflows powered by data and technology. Responsibilities include mapping and optimizing end‑to‑end claims processes, ensuring regulatory compliance, driving automation and scalability, and managing stakeholder expectations. The ideal candidate brings at least 10 years of health‑insurance experience, including 3‑5 years in health‑claims, deep knowledge of health‑insurance products and technology systems, and a proven track‑record of delivering large‑scale insurance system implementations. Strong analytical, communication, negotiation, and problem‑solving skills are essential, as is the ability to thrive in a collaborative, customer‑focused environment.
What you’ll do
- Collaborate and co-create with cross functional workstreams for new products, processes, testing and implementation.
- Co-create, implement, launch, and manage a customer-centric Claims Management function/ workflow powered by Data & Technology.
- Ensure that processes & technologies are designed focus on automation, scalability, and productivity.
What you’ll bring
Have atleast 10 years of total experience in health insurance functions and 3-5 years’ experience in Health Claims insurance is required.