About the role
About Us
Bandhan Life is your trusted partner in financial security, making every Indian household financially secure. As a part of the renowned Bandhan Group, we are bolstering our collaborative strengths of digital innovation and robust distribution to enhance the value for all our stakeholders. Welcome to a new era of insurance, where growth, innovation, customer, and employee welfare are paramount.
Role Overview:
This role is responsible for ensuring operational excellence in medical and scrutiny processes, managing TPA relationships, and driving automation initiatives. The role focuses on compliance, efficiency, and stakeholder engagement to deliver a seamless pre-issuance experience.
Key Focus Areas:
·Operational KPI Management
oEnsure daily operational KPIs are met, including medical completion TAT, scrutiny, and pendency management.
oMonitor performance dashboards and implement corrective actions.
·Stakeholder Coordination
oCoordinate with internal teams, clients, and external stakeholders for TPA and scrutiny-related queries and clarifications.
oMaintain effective communication channels for timely resolution.
·TPA Exception Handling & Escalations
oMonitor TPA exceptions and handle high-value escalations.
oEnsure timely resolution and maintain service quality standards.
·Process Optimization & Automation
oIdentify process bottlenecks and lead cross-functional initiatives to automate and streamline scrutiny and TPA workflows.
oCollaborate with technology teams for implementation.
·TPA Performance Monitoring
oTrack and review TPA performance against defined SLAs and TAT.
oShare periodic performance reports with stakeholders.
·TPA Empanelment & Governance
oHandle empanelment, mystery shopping, and periodic renewal of TPA partners.
oEnsure compliance with contractual and regulatory requirements.
·Assisted PIVV & Welcome Calling
oTrack efficiency of Assisted PIVV and Welcome calling processes.
oEnsure adherence to quality and compliance standards.
·Commercial & Billing Management
oMonitor commercial terms, validate billing, and reconcile invoices.
oEnsure accuracy and adherence to financial governance.
·Escalation Management
oManage escalations related to medical and scrutiny processes.
oImplement preventive measures to reduce recurrence.
·Assisted PIVV & Welcome Calling
oTrack efficiency of Assisted PIVV and Welcome calling processes.
oEnsure adherence to quality and compliance standards
Qualifications & Competencies:
·Graduate/Post graduate with atleast 6-8 years’ relevant experience in Medical & Scrutiny Management from Life or Health Industry
·Excellent communication & stakeholder management skills