About the role
Job Purpose • 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)