AVP/Senior Manager - Claims

Role & responsibilities :

• Manage the grievances with internal / external customers
• Responsible to manage the Quality
• Provide guidance and leadership to Processors, and collaborate with other departments to improve outcomes.
• Prepare and Compilation of monthly Audit reports. Handle a Team of Medical Officers. Processing of Claims and Training of Processors on Medical Aspects and new guidelines.
• Implementation of claims operations strategy. Ensure people and claims related processes are managed efficiently.
• Oversee distribution of claims work to the teams. Ensure maintenance of quality and productivity standards at a high level.
• Improve process efficiency through business process re- engineering / automation in order to process more claims with optimal resources.
• Monitor all the outstanding claims. Ensure outstanding claims do not exceed 30 days.
• Provide support in adjudication of claims by members.
• Provide training to new members of the team in claims processing, terms and conditions and other critical aspects.

Intertested candidates can share their profiles to neethu.k@mediassist.in