Assistant Vice President

Title: Assistant Vice President

Grade: L6

Location: Goregaon East

Sub Department: Claims

Department Operations

Job Description:

1.Claims Investigation management for all category of Claims - Death, Health and Critical illness/Health

2.Analysis and assessment of Investigation report , documents and information received from Investigator and move quality closure within stipulated timelines

3.Responsible for accurate claim assessment and speedy decision

4.Vendor management- maintain good numbers of quality investigator as per requirement , fresh on-boarding, elimination/dis-empanelment of poor performer, monitor timely payment to all vendors (Investigation billing)

5.Monthly Investigator performance review, integrity check, industry feedback, liaising with Legal and Risk team for action

6.Responsible for Vendor / Investigator related communication, Regular engagements with Investigator and industry peers to build relations

7.Responsible for Claims investigation data management for all reports, MIS, Internal and external audits

8.Responsible for any system enhancements/Automation

9.Fraud detection ability, trend analysis and suggestion to put mitigation plan