Job Purpose - Quality Assurance: Develops audit process and auditing of open and closed claims across all LOB's in line with set process and SOP- s, establish, and enforce quality assurance standards and measures for the claim's services within claims department. - Regulatory awareness: Well-versed with Regulatory guidelines like IRDA, GIC etc.) develop awareness and build process to ensures compliance with internal procedures, and maintains knowledge of industry, - Audit management: Coordinates closely work with Internal and external auditors during audit period and audit report review period, to download the improvement and action points to team. - Governance, risk and control: Applies a thorough understanding of governance, risk, and control appropriate to the department and organization to adhere and comply to Regulatory guidelines including PPP - Business acumen: Maintains expertise of the business environment, industry practices, and specific organizational factors - Improvement &amp; innovation: Embraces change and drives improvement and innovation, evaluate internal control and make recommendations on how to improve - Proactive: Makes recommendations proactively for the best ways for a company to avoid risk &amp; fraud Key Responsibilities / Accountability&nbsp; Strategic / Functional (80%) - Ensures claims department complies with internal regulations and established control protocol developed internally abiding organizational policies and Regulatory guidelines. - Participate in audit engagement planning, reporting, scoping, execution &amp; follow-up as defined - Conduct timely implementation of risk-based internal audits as directed by controller complying with annual audit plan - Implement internal audit tasks in areas of risk management and internal control - Perform all assigned audit assignment at financial, operational, Customer communication and administrative processes and systems - Evaluate internal audit suitability, efficiency and evaluate comprehensive business processes and transactions to analyze productiveness of controls and risk alleviation - Conduct testing adhering with accreditation and varied regulatory requirements - Set standards for external vendors audit guidelines, develop road map for audit and conduct periodic audit on performance management, financials, delivery timelines, TAT, serviceability's and communications of such vendors like (salvage Vendors, Health Experts, TPA, Garages, Surveyors etc) - Keeping up to date with industry and regulatory changes and professional standards - Examines documentation, including reports, statements, and memos to gather information - Point of contact from the claim department for regulatory, internal, external audits &amp; claims related escalations on grievance cell, social media, consumer forum or any other legal forum - Completes standard paperwork and questionnaires to confirm internal controls - Participates in meetings with individuals and departments to update auditees on findings and the audit process - Analytics knowledge to deep dive into claims MIS &amp; Registers, set scope and parameters for selecting samples for Audit, the capability to prepare MIS and analysis. - Expert in MS office (excel, Word, PPT, Developing process flow charts and process manuals, SOP's etc - Prepares reports and preserves documentation pertaining to audits for internal record - Presents summarised findings concerning audit results and trends for internal groups - Technical writing experience in relevant areas audit reports and presentations People / team work (20%) - Coordinate within claims team across all LOB's located at Central office or at Regional offices, External Vendors involved in Claims Management, internal auditors, risk management team, compliance team &amp; finance team where ever necessary - Persuades and motivates others through collaboration and cooperation, also provide training to the claims team post receiving the observations from auditors - Works with all department whenever necessary to achieve company goals Knowledge/Skills &amp; Experience Desired Qualifications - Graduation or equivalent qualification in any faculty from a recognized University/Institution. Or 3 years full time Diploma from recognised universities - Good command on written and spoken English &amp; Hindi/Other spoken languages - Good system command on MIS, Analytics, Excel, Word, PPT and acumen to understand and test vendor applications, any other Tech applications either internal or external used for claims administration - Must be able to align with departmental and organisation DNA and objective, to work as team member in COE and coordinate within the team to demonstrate consistent high performance with a concept of Standardization, implementation - Renew, Review of Process SOPs &amp; manuals at set intervals and frequency, suggest changes and amendments from audit outcomes to attain continuous improvements and adherence to internal compliances and regulatory compliances. - The Certified Internal Auditor certification is preferred. Desired Knowledge - 2-3 years of work experience in an internal audit environment in the claims department - Excellent report-writing skills - The thoroughness of the regulatory requirement - Proficient in advanced Excel &amp; PowerPoint Desired Skillset - Excellent documentation &amp; record keeping skills - Business acumen, organizational &amp; communication skills - Change management &amp; planning skills - Analytical thinker with strong conceptual and problem-solving skills - Strong creative/innovative skills (The ability to think out of the box.) Desired Experience - 5-7 years of experience in insurance industry in which 2-3 years in claims / internal audit department across all LOB- s - Preferred working experience within the industry in claim department - Understanding of the insurance industry business model Personal Attributes - Big Picture: You have a clear understanding of the organization's vision and strategy and how your contribution helps Acko Claims succeed. You should be able to understand the requirement of support functions and business success - Commercially Smart: You understand the importance of the insurance industry and the role it plays in safe-guarding Acko's future. - Learning &amp; Developing: You should be willing to be coached for self-development and achieving organizational. - Innovation: You are open to different ways of thinking, new opportunities &amp; approaches. - One Team: You interact effectively within and across teams and contribute towards the success of shared team goals. You build a constructive team environment by demonstrating the Attitudes and supporting others to develop them. Key Relationship/customers Internal: Claims team, tech team, finance, internal auditors, risk management, compliance, product &amp; business, operations &amp; U/W team External: Regulators &amp; external auditors, Vendors, Surveyors, Garages, parts suppliers, expert opinion channels, TPA's.

Bangalore

Acko - Manager - Internal Audit/Assurance - Claims Department 

Acko - Manager - Internal Audit/Assurance - Claims Department  ,Job Description for Acko - Manager - Internal Audit/Assurance - Claims Department  in Acko General Insurance in  Bangalore for (5-7) years of experience. Apply Now!

Job Description for Acko - Manager - Internal Audit/Assurance - Claims Department  in Acko General Insurance in  Bangalore for (5-7) years of experience. Apply Now!