Am Claims

13 hours ago

Thane, India Acumont Solutions Private Limited Full time

We Are hiringAM Claim
Location: Thane, Mumbai
Experience : 3 to 10 years
Qualification : BAMS, BHMS, MBBS, BDS
Working Days : 5 Day

Key Challenges for the role
- Knowledge of Claims processes: Indemnity (Cashless, Reimbursement), Fixed Benefit Products
- Understanding of Claims systems (process flow & System fields) - Health, PA & Travel
- Experience in measurement of performance (TAT, accuracy in claims adjudication)
- Expectations management of the Claims team
- TAT & expectations management for specialized business handling.
- Ensure uniformity in quality & maintain TATs of Claims decisions
- Create & maintain standards/protocols for Claims team
- Audit claims decisions in adherence & compliance with the Claims guidelines, uniformity in decisions, and approval
authority limits (In house and TPA claims)
- Periodic portfolio analysis: profitability (loss ratio / combined ratio), analyze frequency and severity, medical inflation
- Maintain a consistent service delivery to ensure client retention and satisfaction
- Identify risks to the company and escalate accordingly
- Execution of processes and projects -operations, to be in line with defined standards
- Inputs for refinement and development of claims guidelines, policies, and procedures.

**Salary**: ₹300,000.00 - ₹500,000.00 per year

**Speak with the employer**
+91 8200462963

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