Assistant Vice President - Claims Hub - Stand Alone Health Insurance

Job Summary :

- This role is responsible for the smooth operational functioning of the Claims HUB under his/ her supervision

- The role will also be responsible for managing the claims ratio for the organisation

About the Client :

Client is a leading stand alone Health Insurance company.

Job Description :

- Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

- Resolve complex, severe exposure claims, using high service oriented file handling.

- Pay and process claims within designated authority level.

- Examine claims investigated by claims processors, further investigating questionable claims to determine whether to authorise payments.

- Recruit, empower, plan and lead the processing team of the hub (approx team size is 150)

- Development and publication of adjudication guidelines to the processors for standardisation

- Assist the organisation in development and implementation of loss management initiatives

- Monitoring team's performance against the agreed organisational objectives

- Innovate and drive improvement initiatives in the process

- Deliver exceptional customer experience by timely and error free processing of claims

Candidate Profile :

- 8+ years of experience in people and process management

- Six Sigma Green Belt or Black Belt is mandatory

- Candidates experience with Claims management process are preferred

- However, also open to looking at process managers from Insurance, BFSI, Telecom etc.

- Strong hand on process knowledge

- Experience in insurance or other financial service industry

- Knowledge and experience of insurance claims adjudication, would be added advantage

- Graduate or postgraduate (preferably in management)

- PG qualification in Management will be a distinct advantage