Key objectives of the position:
Analysis and Auditing of claims. Identifying claim trends and suggesting corrective measures. Ensuring process and policy terms adherence.
- Claim ratio calculation, monitoring and publishing the claim ratio dashboard.
- Holding primary discussions with internal stakeholders and sharing findings and way ahead for programs/policies.
- Claim assessment and process audits. Auditing adherence of policy terms by claims team.
- Program/policy wise risk analysis.
- Regular reviews with Business and product teams. Suggesting and implementing required changes in the product/policy.
- Assess and analyzing potential fraud cases and identifying trends in frauds and taking/suggesting corrective measures
- Managing fraud claim investigations team.
6-8 years of experience in claims processing. Should be working for an insurance company or Insurance broker.
MBA will be added advantage
- Ability to engage with Employees across levels
- Ability to handle conflicts and grievance handling
- High level of empathy with good listening skills
- Strong people skills to assess behavioral & values alignment
- Highly skilled in process management with eye for detailing
- Vendor management experience to get desired SLA output
- Go-Getter, self starter
- Bias for action, Execution & speed
- Open to ideas and eager to experiment
- Collaborative approach with ease in dealing with multiple stakeholders and teams
- Task focused with passion for employee experience & satisfaction
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