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Senior Underwriter
2 weeks ago
A position overview of the underwriting manager role is as follows:
Key Responsibilities- Responsible for health claim processing including end-to-end processing of claims and turnaround time management.
- Expertise in reviewing claim documents, medical opinions, and understanding policy terms and conditions.
- Risk assessment and triggering verification of suspicious claims.
- Should be able to coordinate with various teams for claims processing, escalations, and litigation cases.
- Team management.
- Reports to: Senior Manager.
- Supervises: Assistant Manager.
- Geographic area covered: Pan India.
- Internal stakeholders: FIU team, sales team, product team, legal team, complaints team.
- External: Customer/Policyholder, Vendor- Prorisk/ Medi Assist.
- Ensure quality & accuracy of Health Claim processes.
- Good knowledge on insurance & products & ability to take claim decisions as per policy terms and conditions.
- Ensure 100% quality completion of Claim decision.
- Presenting case summary and representing to reinsurers, communicating with distribution stakeholders.
- Manage entire team and responsible for End to end TATs of Health claims as per regulatory guidelines.
- Medical background, education - minimum BAMS / BHMS / BDS.
- Effective presentation and interpersonal skills.
- Good system skills in Excel/Word.
- Multitasking.
- This role offers a challenging and rewarding work environment.
- Opportunities for professional growth and development.
- Collaborative and dynamic team culture.
The ideal candidate will have a minimum of 8-12 years of experience in Health claim processing and a strong medical background.
