Claims Processing & ComplianceEnsure timely and compliant execution of all TAT-based activities across all HUBs.Monitor adherence to defined turnaround times and escalate deviations as needed.Help to local team in to coordinate with Operations and ILM teams to ensure complete and clear documentation of all claim's cases for the region.Automation & System EnhancementAct as a bridge between the Legal Processing Unit (LPU) and the Automation / Development team.Participate in UAT (User Acceptance Testing), receive training on new developments, and disseminate updates across the pan-India LPU network.Support API management for intimation and orders related to MACT, Consumer, and Appeal cases.Consumer Litigation CoordinationCollect, clean, and consolidate data from LPU teams across India for consumer litigation cases (currently managed outside the system).Ensure timely and accurate submission of data to the central consumer litigation team for compliance and further processing.Collect and summarize data from teams for reporting and analysis.Generate the MIS and coordinate data across two systems – OPUS and Maximus / FA – including report generation.Generate the report from the system and share the inputs for optimize processes for data intake and ensure data quality by reviewing BO reports and performance indicators.NEFT Payments OversightGenerate the MIS on NEFT payments for PAN India claims and ensure timely processing and reconciliation share the report and support with Manager and other team member as well .Process Governance & FeedbackSupport team members in understanding and adhering to defined processes.Gather feedback from teams on process challenges and improvement suggestions.Communicate insights and recommendations to the Manager for resolution and system enhancement.Scope Expansion & CriticalityProactively identify opportunities to expand the scope and improve the criticality of the role in alignment with business needs.Data Maintenance & ReportingResponsible for maintaining approximately 60,000 open claim counts across various categories :MACT, HC, Consumer, WC, Civil Suit, Ombudsman, Arbitration
- Collect and summarize data from teams for reporting and analysis.
- Monitor and coordinate data across two systems – OPUS and Maximus / FA – including report generation.
- Relationship Management
- Collaborate monthly with the ILM team to identify fraudulent cases and analyze regional trends.
- Coordinate with the internal accounts team to ensure timely payments and accuracy of financial records.
- Management and Development
- Prepare individual performance reports for the pan-India LPU team.
- Schedule regular meetings to identify bottlenecks. Maintain the MOM of each meeting and make sure of compliance to be done from the team with in decided time line
- Coordinate with other verticals and teams to resolve issues related to claims processing and system workflows.
- Process Changes & Documentation :
- Coordinate with stakeholders to understand changes in regulatory or operational procedures (e.g., TDS updates, NEFT mandates), and assist in drafting revised process documents for Managerial review and approval.
11 . Audit Preparedness
- During internal and external audits, the candidate is responsible for retrieving claims files and
supporting documentation, ensuring timely coordination with local teams to meet compliance deadlines.
- Regulatory & Process Updates
Adapting to changes such as the New Motor Vehicle Act, Supreme Court orders on claim intimation, and updates to financial procedures (e.g., NEFT mandates, TDS rate changes) requires proactive coordination with stakeholders.
Skills Required
Report Generation, Data Maintenance, Relationship Management, Api Management