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