
Senior Manager
2 weeks ago
Job Summary:
The position will involve claims analysis and processing facilitation in coordination with different TPA's and Insurance companies.
Responsibilities:
- Leading team and reduce escalations to the maximum extent possible.
- Managing relations with TPAs/Insurers to ensure claims SLA is maintained.
- Interacting with client HRs to resolve their claims related queries, if required.
- Explaining clients on the policy terms related queries over the call or mail.
- Reviewing denial claims sent by TPAs & ensuring that denial is done as per policy terms.
- Representing client claims to insurer/TPA in case of ambiguity in settlement/denial
- Supporting Analytics team in data analytics.
- Managing the assigned team members day to day activity & their productivity to ensure excellent client experience.
- Visiting insurer office whenever required to get the necessary approvals on claims.
- Supporting client servicing teams in claims related issues whenever required.
Desired profile/who should join:
- Should be a graduate with any specialization.
- Should have 10-15 years of experience in Managing EB Claims teams processing (Cashless/Reimbursements)
- Good knowledge about the TPA/Insurance processes
- Well verse with health insurance policy conditions
- Well verse with current medical practices & advancements
- Should have knowledge about IRDA health regulations
- Good communication skills
- Problem solving attitude
- Team leading
- Mentoring Skills
- Decision making
- Good team manager
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