Bajaj Allianz - Senior Manager - Motor OD Claims (10-15 yrs)

Senior Manager Motor OD Claims

Responsibilities:

- Provide direction and leadership to the loss minimization team, ensuring that all activities align with the company's goals and values.

- Implement policies and procedures related to loss minimization and claim processing, ensuring that they are following industry regulations and best practices.

- Oversee the review of high-value, complex, or sensitive claims, working closely with internal and external stakeholders to ensure prompt and exact resolution.

- Establish and support relationships with external partners, such as claim service providers and industry associations, to stay up to date with emerging trends and best practices.

- Review and analyze claim data to find patterns, trends, and potential areas of improvement, and give feedback / intimate / trigger process excellence team to mitigate future losses.

- Collaborate with other departments, such as underwriting and legal, to review risk mitigation strategies that minimize the claims exposure to potential losses.

- Manage and develop a team of loss minimization professionals, supplying guidance and support to ensure that they are equipped to meet their goals and aims.

- Ensure that all claims are overseen by company policies and procedures, and that all stakeholders are treated fairly and with respect.

- Develop and support performance metrics and reporting systems to track the success of loss minimization efforts and make recommendations for process improvements as needed.

- Coordinating with Internal Corporate Audit team on Audit observation and closer of observation.

- Generate preventive exception report within team to identify gaps in process and system.

- Coordinating with External Statutory Auditor for department related Audit, arranging samples & closing audit observations

- Coordinating with IFC auditor, as and when required, arranging samples & closing audit observations.

- Conducting monthly IFC internal audit on listed parameter within team to submit IFC compliance certificate.

- Coordinating with RISK team on risk related sample verification and introducing / designing new process to mitigate risk.

- Claims Management and Loss Minimization

Analysis and Reporting

- Analyze audit findings and finding trends and patterns in the data. Collaborate closely with the other stakeholders to find areas for improvement and develop strategies to address these issues.

- Lead R2R discussions with claims team as a subject matter specialist

- Design common operational framework to enable stability, consistency, and efficiency of 50+ R2R processes.

- Brings technical and subject matter ability to all R&CA related discussions.

- Doing independent research, analyze, and present data as assigned Critically examine and deep dive into records.

Claims Management and Loss Minimization

- Review the E2E Metrics and find risks, opportunities, Own the standard process design and control environment.

- Manage the claim audit process from start to finish. This includes finding claims that need to be audited, assigning auditors to specific claims, reviewing audit findings, and communicating the results to the claims department.

- Ensure that claims are processed in compliance with company policies and regulations. Monitoring the performance of the claim auditors and ensuring that they are following company policies and regulations.

- Monitor effectiveness of all programs (OFR, CFR, M-OTS, Theft & PA Claims) and supply support to all open claim file reviews and manage all payment cycle to ensure compliance to all contract requirements.

- Develop and implement audit procedures to ensure that claims are processed accurately and in compliance with company policies and regulations. Work closely with the claims department to ensure that these procedures are effective and efficient.

- Communicate audit findings to the claims department, underwriters, and other stakeholders. Ensuring that these stakeholders understand the audit findings and are taking the necessary actions to address any issues.

- Recommend improvements in processes to increase ability and supervise effective resolution of all claim inquiries.

- Drive a culture of continuous risk assessment, mitigation, and proper customer communication.

- Build impactful customer relationships; improve Net Promoter Score. maintain an existing book of business, and drive revenue growth.

- Drive implementation of transformation projects from process excellence team, digital asset implementation, standard methodologies' framework, case studies, benchmarking for making processes more efficient and effective

- Build impactful customer relationships; improve Net Promoter Score.

Analysis and Reporting

- Analyze audit findings and finding trends and patterns in the data. Collaborate closely with the other stakeholders to find areas for improvement and develop strategies to address these issues.

- Lead R2R discussions with claims team as a subject matter specialist

- Design common operational framework to enable stability, consistency, and efficiency of 50+ R2R processes.

- Brings technical and subject matter ability to all R&CA related discussions.

- Doing independent research, analyze, and present data as assigned Critically examine and deep dive into records.

- Prepare detailed documentation of analytical solutions and preparing presentations.

- Ensure compliance with Data Privacy and Protection Guidelines

Internal / External Audits

- Address any review points raised during Audit Review by Internal Audit and Statutory Audit.

- Timely attend all the internal and external audits as per the Annual Audit Calendar and companies audit requirements.

- Adherence to Audit coverage versus scope (as finalized by the Management)

- Timely preparation of Quality data for audit and ensure follow-up discussions for closure.

- Support in various identified Special Assignments

- Effective coordination with Outsourced CA Firm and ensure prompt closure of audit reports post discussion with stakeholders.

- Ensure Action is taken for inconsistencies seen and reporting on Action Taken Status.

- Conduct meetings with process owners for prompt update on open audit observations.

- Performs independent testing of ATR observations. Supply monthly updates to process owners / NHoD on the progress of audit actionable.

- Finalize monthly dashboard on Action taken status and appraise NHoD on open audit observations.

- Report open audit findings to the management; Lead interactions with internal stakeholders for speedy resolution of found issues.

- Figure out whether areas reviewed / audited are performing control activities in compliance with applicable policies and procedures and in a manner consistent with both organizational goals and exacting standards of administrative practice.

- Assess robustness of SOP's find control gaps proactively and coordinate with quality assurance team for remediation of gaps.

- Supply governance support for customer / employee campaigns and lead as an auditee for all regulatory audits.

- Lead the execution of Annual Risk Assessment Program covering the operational and claim related risks. Present the results of Risk Assessment to the NHoD and the risk committee. Perform quarterly/ periodic updates of the key risks found in the Risk Assessment.

- Assist / Mentor the quality assurance team in developing / reviewing internal control environment / processes for various market specific initiatives.

Team Management

- Develop staff by assessing Leadership competencies and promote training and career planning, coach employees for career development. Supplies input s into hiring decisions.

- Manage a team of claim auditors. This includes hiring, training, and evaluating the performance of the team. Setting goals and aims for the team and ensuring that they are met.

- Forecast all staffing requirements and find and resolve all issues effectively and schedule all employee attendance.

- Focus on enhancing domain knowledge, soft skills, and ability.

- Drive growth in productivity and overall team success through improved skills and performance.

Minimum Qualification: Degree / Diploma in Automobile / Mechanical Engineering

Surveyors license from IRDA (Optional)

Insurance certified courses and Any Management course (Optional)