Chief Manager - Health Claims - Insurance

Job Description :

1. Claims approvals within the given authority level

2. Monitor claims movement, claim reserve and manage Outstanding claims

3. Ensure TPA and in-house claims team follows regulatory guidelines.

4. Review quality of claims handling basic the company's claims philosophy and guidelines

5. Review customer complaints, present RCA and ensure timely resolution

6. Identify red alerts in claims and liaise with Investigation team

7. Liaising with various stakeholder (internal & external) to identify process gaps and implement fix.

8. Should have ability to understand system requirements for claims module of new and existing products