Deputy Officer Job Vacancies in Thane

Job profile: Bringing an outside-in perspective to the stakeholders and convincing them of the same. Understanding the deep insights of the business problem/ underlying risk. Continue study of best practices in risk management in the market and advise the respective function Building and maintaining stakeholder relationship both Internal as well as external To have continued engagement of the various Stakeholders including the Functional teams for driving strategic and process Improvement Initiatives, keeping in view the business goals Data collection for proactively identifying & monitoring operations risk is a challenge Data analysis to building risk models, compliance testing, audits, Board agenda etc. is a core requirement for which the function has to depend on the other function of the organization. Getting correct and timely data is a challenge To document project charter, design document To develop, test, deploy automation solutions Support UAT of automation solutions Conduct user training and support transition User handholding on smooth running of automation solutions Monitor processing logs, server logs & space requirements around automation solutions Fix errors and do performance tweaks in automation solutions Do monthly review of usage, costs and benefits Publish report of usage, costs and benefits Maintain daily MISTechnical skills: Process Excellence, MIS , Insurance, health insurance, medical insuranceSoft skills: Good communication skills, leadership skills, interpersonal skills, analytical skills, , interpersonal skillsEducational Qualification: Any GraduateExperience: 2 or more years of relevant experience in insurance or third part administrator

Job profile Manage high disease risk customers/patients over the phone/emails/EMR and, if required, in person Should understand the medical diseases and finer details of their management protocol along with the finer details of the program construct Follow/Develop a detailed plan of tracking as per the protocol keeping in mind the complications that could arise Coordinate with external customers/patients basis the risk trigger ensuring maximum level of sensitivity and confidentiality while managing cases Managing all cases on a case to case basis ensuring that majority customers/patients are adhering to the program construct Manage changes and escalations effectively on a case to case basis Measure program performance with relevant reports and at define frequency Report and escalate to management as and when needed Successfully manage the relationship with all stakeholders, internal as well as external Perform risk management to minimize risks at a customer level as well as at a portfolio level Establish and maintain relationships with third parties/vendors Review the processes on a timely basis Work towards digitization at each stage Identify opportunity for improvement basis partners feedback Leakage management and Governance around payment, customer benefit utilization Manage Internal & external process Audits Adherence to all Regulatory requirements and quick adaption to regulations Knowledge of DRM processes: Stay abreast with new processes / suggest improvements Understanding of DRM systems (process flow & System fields) TAT & expectations management for specialized business handling. Co-ordinate with other departments, team members and management to ensure smooth information flow to ensure that operations are carried out, recurring issues are resolved. Create & maintain standards/protocols for DRM team Maintain a consistent service delivery to ensure client retention and satisfaction Identify risk

Job profile: Accurate and timely submission of periodic and ad-hoc reports related to Claims Trainings to the partner claim processors regarding policy T&Cs, Time management, Delegation Debit note supervision for all the payments from TPAs & OPD Partners Viz. Coordinating with Partner leadership teams /tech teams for MVP implementations viz In health check-ups utilization should be driven towards home collection instead of hospitals. FWA investigations are to be conducted in the agreed percentage of claims. (Partner end) The reimbursement claims adjudication rule engine (automated) should be aligned with the company process Real time client Dashboard for client reviews. Query management Medicos to process OPD claims Maintain daily MISTechnical skills: Reimbursement claims, MIS , Insurance, health insurance, medical insuranceSoft skills: Good communication skills, leadership skills, interpersonal skills, analytical skills, , interpersonal skillsEducational Qualification: Any GraduateExperience: 2 or more years of relevant experience in insurance or third party administrator