Role &amp; responsibilities

1. Managing claims related issues faced by clients

2. Interacting with TPAs/Insurers to ensure claims SLA is maintained

3. Interacting with client HRs to resolve their claims related queries

4. Managing Team productivity &amp; quality

5. Explaining clients on the policy terms related queries over the call or mail

6. Representing client claims to insurer/TPA in case of ambiguity in settlement/denial

7. Managing the assigned team members day to day activity &amp; their productivity to ensure excellent client experience

8. Visiting insurer offices whenever required to get the necessary approvals on claims

9. Supporting client servicing teams in claims related issues whenever required

10. Working on process improvement via automation

Preferred candidate profile

1. Good knowledge about the TPA/Insurance processes

2. Well verse with health insurance policy conditions

3. Well verse with current Insurance regulations &amp; practices

4. Should have knowledge about IRDA health regulations

5. Good communication skills

6. Problem solving attitude

7. Team player

8. Good team leader

9. Should be well verse with MS office

Sr. Claims Manager in Mumbai (UID-8713)

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Job Description for Sr. Claims Manager

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