Role: Claims Leader (BI/PD)

Job description Role: Claims Leader (BI/PD) Location: Chandigarh, Ambala India Reporting To: Claims Operations USA / Operations Unit India Role Overview Lead the establishment and operations of a strategic Claims Support Center in North India, driving 24/7 excellence in claims processing support for global BI (Bodily Injury) and PD (Property Damage) adjusters. This is a senior leadership role requiring a seasoned professional to build, mentor, and scale a high-performance team from the ground up while ensuring operational excellence, regulatory compliance, and superior stakeholder support. Key Responsibilities Strategic Leadership Establish and operationalize the Claims Support Center within 90 days Develop comprehensive operational procedures, quality standards, and performance metrics Design and implement 24/7 shift operations, including night shifts (6 PM 3 AM IST) Create scalable processes to support global adjuster teams across multiple time zones Claims Process & Workflow Management Design, document, and continuously improve end-to-end claims workflows (FNOL to closure) to enhance speed, quality, and cost efficiency Define and enforce standard operating procedures (SOPs) Monitor claims inventory and workload distribution; recommend actions to balance capacity and meet SLAs Identify bottlenecks or failure points in claims handling and implement practical process improvements Core Analytical & Problem-Solving Skills Analyze claim patterns, exceptions, and outliers to detect potential fraud, leakage, or process gaps Integrate data from claims platforms, CRM systems, document management tools, and billing systems for a holistic claim view Make timely decisions in ambiguous situations aligned with underwriting guidelines and risk appetite Quality, Compliance & Risk Management Ensure regulatory and internal compliance (documentation standards, privacy, fair claims handling, local regulations) Identify claim leakage (overpayments, missed recoveries, unnecessary expenses) and implement preventive controls Develop and review checklists and documentation standards for reserves, settlements, and investigations Adjuster Support & Coaching Serve as subject matter expert and first escalation point for complex coverage or process-related questions Coach and mentor team members on best practices, investigation standards, documentation quality, and negotiation strategies Conduct training sessions on new products, tools, regulatory updates, and process enhancements Communicate complex claims concepts clearly to both new joiners and experienced adjusters Operational Excellence & Team Management Build and manage end-to-end claims support activities including documentation, investigation support, and stakeholder communication Ensure adherence to regulatory requirements and company policies Provide real-time operational support to field adjusters Drive continuous improvement, automation initiatives, and workflow optimization Stakeholder Management Partner closely with BI/PD adjusters to understand evolving support requirements Coordinate with IT for system integration and optimization Collaborate cross-functionally with Underwriting, Legal, SIU/Fraud, Finance, and Operations Represent Claims in projects and workshops, ensuring adjuster and customer impacts are clearly articulated Influence adoption of new tools, processes, and behavioral changes without direct authority Report operational metrics, insights, and strategic initiatives to senior management Required Qualifications Experience & Education 10+ years of claims management experience with demonstrated leadership capability Bachelors or Master’s degree in Business, Finance, Insurance, or related field Hands-on experience in BI (Bodily Injury) and PD (Property Damage) claims is essential Technical Expertise Proficiency in claims management systems Advanced knowledge of insurance regulations and compliance frameworks Strong understanding of investigation procedures and documentation standards Experience in process automation and workflow optimization Leadership Competencies Proven track record of building and scaling high-performance teams from scratch Strong change management and organizational development skills Experience managing 24/7 operations and shift scheduling Core Skills Excellent communication, project management, and interpersonal skills Analytical mindset with strong problem-solving abilities Cultural sensitivity and experience managing diverse, multi-generational teams Preferred Qualifications Professional certifications (CPCU, AIC, ARM, or equivalent) Experience managing offshore/nearshore operations Knowledge of Lean Six Sigma or other process improvement methodologies Familiarity with emerging claims technologies (AI, automation, analytics tools) Role: Claims Manager Industry Type: IT Services & Consulting Department: BFSI, Investments & Trading Employment Type: Full Time, Permanent Role Category: General Insurance Education UG: B.Tech / B.E. in Any Specialization PG: MBA/PGDM in Any Specialization Key Skills Skills highlighted with ‘‘ are preferred keyskills FNOL to closure Claims ManagementPDBIAICARMClaims Processing