Specialist - Claims
2 weeks ago
Job Purpose
·To ensure that insurance claims are handled efficiently and that payment for valid claims are made to the nominee / beneficiary
Key Responsibilities
Responsibilities
·To handle claim assessment and control the process within TAT
·To analyze the case and trigger investigations wherever necessary
·To ensure appropriate scanning of claim documents for fraud check
·To respond to claimant queries / mails properly with prompt action
·To ensure client servicing, prompt reply, action initiation
·To ensuring payment of claim to the correct nominee/beneficiary
·To identify and mitigate the risk in discussion with manager
Specific Authorities( Financial & Non Financial)
·Investigation trigger of Claims for appropriate Assessment
·Appropriate assignment of cases to Reinsurance for Opinion
·Preparation of letters in line with Company policy
Key Performance Indicators
·Accuracy in Claims Assessment & Payout = %
·Customer Management (Email/Calls) with NPS > 50
·Managing Reporting, Compliance and Audit = %
Job Requirements
Qualifications
Graduate/Post Graduate (Preferably in Finance or Statistics)
MBA preferred
Experience
0-6 years of relevant experience
Functional Competencies
• Claims & Risk assessment
• Reporting, Compliance and audits
• Strong background in life insurance Claims
• Possesses understanding trends that affect Claims Function in insurance
Behavioral Competencies
• Good communication and interpersonal skills
• Analytical skills
• Collaboration
• Business Acumen
Key Interactions
Internal
Nature or purpose of interaction
F&A, MIS team
·Daily coordination with finance/accounts team
·Automation requirement discussion
·Data from system MIS/Reports
External
Nature or purpose of interaction
IDRA, clients
·To provide MIS/Reports to IRDA
·To understand IRDA guidelines and updates
·To meet claimant
Documented By
Lead – Lead Claims
Approved By
Head – PS/Fin Ops & Claims
HR certification By
Vice President HR
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