Health Insurance TPA of India - Vice President - Claims Management

- Driving health claims strategy formulation and setting up processes for the function.

- Leading a team handling claims, customer queries & complaints, claim adjudication & registration, quality management, analytics etc..

- Formulating & ensuring claims/reimbursements settlements with superior TAT & customer experience.

- Analyzing incurred claim ratio, review of the portfolio & taking proactive action for loss control measures.

- Developing & implementing health claims fraud prevention & loss mitigation framework.

- Training & development of medical processors. Identifying key learning, gaps and opportunities for individuals to develop the team.

- Drive continuous improvement and assist team as and when vital to make the business run effectively and efficiently.

- Ensure that the highest possible levels of customer service are delivered at all the times.