Non-Medical Claims, Consultant

We are seeking a Non-Medical Claims, Consultant to lead and oversee the strategic and operational management of Individual Life claims. The successful candidate will ensure timely, compliant, and customer-focused service delivery, supporting the company's business goals, regulatory obligations, and departmental KPIs.

Responsibilities:

• Lead Life Claims Operations (30%): Oversee the assessment and governance of Life Claims to ensure timely, accurate, and compliant decisions.
• Drive Strategic Projects and Automation (25%): Lead digital transformation initiatives, including RPA, macro automation, and e-Submission platforms to improve efficiency, reduce manual work, and optimize resources.
• Enhance Process and Productivity (15%): Drive process improvements to boost productivity, reduce turnaround time, and ensure sustainable workload management.
• Stakeholder Engagement and Collaboration (10%): Foster strong partnerships with cross-functional teams to drive strategic initiatives and product launches.
• Team Leadership and Development (10%): Mentor and develop team members, foster engagement, and build a resilient, high-performing team culture.
• Compliance and Quality Assurance (10%): Ensure adherence to regulatory requirements and internal policies, with zero AML breaches and consistent audit compliance.

Requirements:

• Bachelor's Degree in Insurance, Business Administration, Finance, Law, Medical Sciences, or related disciplines.
• Minimum 8–10 years of claims experience within the insurance industry, with significant exposure to handling complex and high-value claims.
• Minimum 3–5 years of people management experience, including leading, coaching, and developing claims teams.
• Strong knowledge of life, health, medical, and major claims assessment principles, claims operations, and regulatory requirements.
• Proven experience in managing complex claims investigations, claim escalations, disputes, and stakeholder negotiations.
• Strong understanding of insurance industry regulations, governance, compliance requirements, and fair claims practices.
• Excellent analytical, decision-making, and problem-solving skills with the ability to exercise sound judgment in complex claim cases.
• Strong stakeholder management and communication skills, with the ability to engage effectively with senior management, reinsurers, medical professionals, legal partners, and external stakeholders.
• Demonstrated ability to drive operational excellence, process improvements, and service quality initiatives.
• Proficient in claims systems, data analysis, and Microsoft Office applications.