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/ group’s policies.

• to identify and prevent regulatory breach of claims tat’s, 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

• policyholder’s 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, delegation
strong 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

  1

• Education

  Any Bachelor Degree

• Role

  Claims Manager

• Industry Type

  Accounting / Finance

• Gender

  [ Male / Female ]

• Job Country

  India

• Type of Job

  Full Time

• Work Location Type

  Work from Office

• Face interview location

  hyderabad