Consultant at Michael Page International
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Assistant Vice President - Claims Hub - Stand Alone Health Insurance (8-20 yrs)
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
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