Senior Manager Claims Mumbai

Satvam Consulting Private Limited

Job profile:

To ensure to publish MIS, Regulatory Data submission, Analysis on periodic basis with effective controls built in and allied activities by overcoming system and infrastructure constraints.

To identify trends, alert and suggest strategies towards risk/fraud mitigation strategies and policies within the framework of Compliance/ Groups Policies.

To identify and prevent regulatory breach of Claims TATs, and timely data submission by overcoming challenges related to systems and infrastructure, using manual methods where required.

Accurate and timely submission of periodic and ad-hoc reports related to Claims to the Regulatory Authority/GI Council

Audits: IRDA, Internal, Stat, others

Data submission/query response/ad-hoc reports to IRDA/GI Council

Closure of audit observations

Monthly / Quarterly / Annual Data submission

Policyholders protection committee, Quarterly board meetings, monthly Ops Review, Weekly Claims Review

Develop, Implement shortcuts, macros, formulae on excel, using alternative tools/methods for timely submission

Develop, train the team, delegate and review their accountability

Do cursory/sanity check before submission

Team training, Time management, DelegationStrong coordination skills with other departments, sharp and on the spot thinking, proactive approach, soft skills, excel skills, working with other tools/macros

Work closely with Finance, Actuary, Operations, Internal Claims team.

To decide on complex claims, reconsideration claims and claims beyond the authority of the Claims Department

To decide on complex claims, ex-gratia claims, reconsideration claims and claims beyond the authority of the Claims Committee

Business forecast, MIS, query resolutions etc.

Claims status, query resolutions, MIS

System issues, queries, testing and system developments/ enhancements

Technical skills: Reimbursement claims, MIS , Insurance, health insurance, medical insurance

Soft skills: Team leader

Experience : 7 - 10 Years

No. of Openings : 3

Education : Any Bachelor Degree

Role : Claims Manager

Industry Type : Insurance / Claims

Gender : [ Male / Female ]

Job Country : India