Associate Vice President

6 days ago

Hyderabad, Telangana, India ICICI Lombard Full time ₹ 20,00,000 - ₹ 25,00,000 per year

Role & responsibilities

  • Strong knowledge of Health Insurance and products
  • Must have a minimum of 10 years experience in health claims management with over 5 years managerial experience.
  • The candidate can be from health insurance, general insurance, reinsurance, or life insurance industries.
  • Extensive experience in health claims processing and administration.
  • Proficient in health claim fraud prevention & loss mitigation framework.
  • Should have experience in managing large teams
  • Understanding of Health Claims and claim related processes
  • Lead a team handling claims, customer queries & complaints, risk & Loss mitigation team , Implement & monitor framework designed.
  • Drive health claims policy formulation and optimizing the processes for the function.
  • Supervision and medical review of high loss health indemnity claims
  • Formulate & ensure faster claims settlement with superior TAT & customer experience.
  • Analyze incurred claims ratio, review of portfolio, and take proactive action for loss control measures.
  • Stay up to date on amendments and provisions in health insurance regulations & implement changes in claims processes to ensure compliance.
  • Conduct Medical data analytics, reporting for the stakeholders like (department head, management committee, regulator, IIB etc.) on defined intervals.
  • Train & develop medical processors. Identify key learnings, gaps, and opportunities for individuals to develop the team.
  • Build & maintain a relationship with external service partners including but not limited to Sales channel partners, Hospitals etc

Preferred candidate profile

  • MBBS/BHMS/BAMS and MBA Hospital Administration
  • MBA in Hospital Management / Insurance / Fellow from Insurance Institute of India, Six Sigma Green/ Black belt

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