Senior Manager HR Recuitment at Upman Placements
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Deputy General Manager - Claims - Life/Health Insurance (8-18 yrs)
- Overall responsibility of managing Individual & Group claims function including rider/health claims. Position reporting to the Vice president- CSO. Ensuring that all eligible claims are paid accurately and speedily.
- Monitor the TATs / responsible for reporting claims statistics internally and to the Regulator.
- Managing/coordinating with other departments/investigators/vendors. Digitising the claims process.
- Oversees the claims process to meet strategical/operational/financial/service requirements.
- Keeping pace with necessary regulatory/compliance changes.
- Maintaining the industry best practices/ advancing in technological changes.
- Guide the team with respect to analyzing and interpreting medical documents and understanding diseases (their etiology, symptoms, treatment and prognosis)
- Coordination with external medical entities like doctors, clinics, pharmacies, hospitals and visits where needed
- Coordination with internal departments like Underwriting, Legal, AFT, BA as required in the process of each claim
- Coordination with external investigators
- Regular follow up on the pending claims (coordinate and communicate with branches, advisors and claimant for completion of documentation) and reporting on the same
- Maintain stricter TATs and reduce average claim processing time through various interventions.
- Review various key metrics to avoid any leakages at claims stage and provide timely feedback to various departments at every level to reduce outflow of claims.
- Responsible to arrange various timely business MIS internally and externally
- Coordinating with IT to implement new technologies/process improvements in claims process.
- Implement operational best practices with various process/financial controls