Cashless / Provider Network (Health Claim)

Cashless / Provider Network (Health Claim) - Leading General Insurance - Pune (Hinjewadi)

Purpose of this role : Team Management, achieving KPIs, Claims Management and People Management.

Main Responsibility

1.Monitoring TATs and KPIs of Cashless Team.

2.Detection of frauds and prevention of claim leakages.

3.Hand holding and grooming of team members.

4.Monitoring and controlling the team member’s performance.

5.Resolution of queries, requests, and complaints within committed TATs.

6. Need based skills enhancement and technical training for employees.

7. Co-ordination with Branch and other external customers.

8. Completion of Project / Task work as assigned.

9. To ensure smooth functioning of Claims processes.

10. Customer Orientation, Initiative, Communication & Analytical Thinking

Provider Network-

Leading a team members distributed across different geographies PAN India.

Team handling and driving discount savings / tariff negotiation and procurement

Implementing strategies to curb claim leakages, portfolio maintenance.

Audit and control

Interdepartmental coordination for smooth running of function and monitoring deliverables.

Working on IRDA initiatives of Cashless Everywhere

Qualification and Experience Requirement

Education

: Graduate in any discipline or MBA

Experience

: Experience of minimum 5 to 10 years in any TPA / Insurance Company in a similar function