Process Manager - Claims - Life Insurance

Process Manager - Claims - Life Insurance

Job Purpose : To ensure that insurance claims are handled efficiently and that payment for valid claims are made to the nominee / beneficiary

Key Responsibilities :

- To handle claim assessment and control the process within TAT

- To analyze the case and trigger investigations wherever necessary

- To ensure appropriate scanning of claim documents for fraud check

- To respond to claimant queries / mails properly with prompt action

- To ensure client servicing, prompt reply, action initiation

- To ensuring payment of claim to the correct nominee/beneficiary

- To identify and mitigate the risk in discussion with manager

Specific Authorities( Financial & Non Financial) :

- Investigation trigger of Claims for appropriate Assessment

- Appropriate assignment of cases to Reinsurance for Opinion

- Preparation of letters in line with Company policy

Internal Key Performance Indicators :

- Accuracy in Claims Assessment & Payout = 100%

- Customer Management (Email/Calls) with NPS > 50

Job Requirements :

Qualifications : Graduate/Post Graduate (Preferably in Finance or Statistics)

Experience : 0-4 years of relevant experience

Functional Competencies :

- Claims & Risk assessment

- Reporting, Compliance and audits

- Analytical skills

- Process & System knowledge

Behavioral Competencies :

- Execution Excellence

- Customer Centricity

- Collaboration

- Business Acumen

Key Interactions :

Internal Nature or purpose of interaction :

- F&A, MIS team

- Daily coordination with finance/accounts team

- Automation requirement discussion

- Data from system MIS/Reports

External Nature or purpose of interaction :

- IDRA, clients

- To coordinate with claimants for documents, claim status

- To understand IRDA guidelines and updates

- To coordinate with Vendors for investigating potentially fraudulent claims