Skills &amp; Qualification

<ul>
<li>Strong knowledge of health insurance and claims investigation processes</li>
</ul>

<ul>
<li>Excellent communication and interpersonal skills to effectively manage vendors and stakeholders</li>
</ul>

<ul>
<li>Ability to analyze data and identify trends to improve investigation processes</li>
</ul>

<ul>
<li>Strong problem-solving skills to resolve complex claims investigations</li>
</ul>

<ul>
<li>Ability to work efficiently under pressure and meet deadlines</li>
</ul>

<ul>
<li>Proficient in Microsoft Office Suite, particularly Excel, Word, and PowerPoint</li>
</ul>

<ul>
<li>Strong leadership and management skills to effectively manage a team</li>
</ul>

<ul>
<li>Ability to travel to carry out field investigations</li>
</ul>

Responsibilities

<ul>
<li>Follow the Standard Operating Procedure (SOP) laid out for Health Claims Investigations</li>
</ul>

<ul>
<li>Takes full responsibility of managing health claims investigations, including allocation of cases to external vendors, follow-up for reports, and quality control of investigation reports</li>
</ul>

<ul>
<li>Will be willing to travel to carry out field investigations</li>
</ul>

<ul>
<li>Ensures to get the investigation reports within the prescribed Turn-Around-Time (TAT)</li>
</ul>

<ul>
<li>Maintains the quality of investigation reports from vendors by conducting regular quality checks</li>
</ul>

<ul>
<li>Provides proactive assistance to the Health Claims team to achieve customer delight and high-level customer satisfaction for the insured and internal stakeholders</li>
</ul>

<ul>
<li>Works efficiently to meet set goals and avoids any escalations to maintain relevance and quality while providing service to stakeholders</li>
</ul>

<ul>
<li>Handles vendor management, including obtaining SLAs and documents for empanelment</li>
</ul>

<ul>
<li>Handles projects and additional tasks assigned</li>
</ul>

Claims Manager in Bengaluru (UID-14129)

Job Description

Job Details

Skills Required for Claims Manager

Job Description for Claims Manager

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