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Cluster Manager-ILM- Health Investigations
6-8 years
Pune
1 vacancy
Cluster Manager-ILM- Health Investigations
Bajaj Allianz General Insurance
posted 4d ago
Job Role Insights
Flexible timing
Key skills for the job
Job Description
- Trigger identification through data at intimation/Referral stage
- Social media searches
- Cold calling using digital platforms
- Identify key business people, link analysis
- Allocation of assigned claims to respective vendors with case relevant triggers
- Follow up for IR and TAT management
- Level 1 QC clearance & validate the submissions against shared triggers
- Success in claim investigation based upon strong medical & legal evidences
- Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing & creating evidence which stands in court of law
- Report submission and coordination with claims team.
- Ascertain evidence quality as per matrix
- Validate each & every evidence with the case triggers
- DMS of hardcopy maintenance
- Document Complaince through Field Investigation of HVC
- Further Requirement Complaince
- OFR and CFR with Stake holders
- MIS preparation and report reconciliation
- Payment reconciliation with Vendors
- Project tracking
- Vendor Empanelment & Training & Development
- Ensure the ethics and compliance during managing the external investigators and self- investigation of cases
- Vendor Payment Reconciliation
Employment Type: Full Time, Permanent
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Rating based on 8 Cluster Manager
reviews
Anonymous · Doctor
in Pune
Nothing as of now
Poor management and no work life balance
Read 8 reviewsCluster Manager salary at Bajaj Allianz General Insurance
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