Shriram Life Insurance - Senior Manager - New Business Operations
Shriram Life InsuranceHyderabad, India4 days ago
Job descriptionPrior experience in Medical TPA management for Life Insurance sector Must have basic knowledge of Underwriting guidelines & norms Must be able to supervise a small team Must have a strong process orientation Establish and manage relationships with Medical TPAs (e.g. Mediassist, Health India) for outsourced medical testing operations; Execute / renew contracts with TPAs after negotiating costs and agreement terms in coordination with the Legal team Set-up, define and communicate SLIC SOPs and guidelines for medical testing operations to TPAs; Ensure SLAs and activity wise TATs are clearly understood and agreed by TPAs Review and finalize mapping of empanelled Diagnostic Centers in coordination with TPAs; Ensure availability of medical testing facilities for all SLIC branches / locations Review and monitor TPA service levels and adherence to SOPs on a continuous basis; Ensure TATs for medical registration, uploading medical reports, submission of original reports etc. are maintained Plan and organize Mystery Shopping audits at Diagnostic Centers in coordination with branches / divisional offices; Review audit feedback regarding quality of service, adherence to SOPs and escalate issues / lapses with concerned TPAs Review and monitor medical pendency cases across branches / divisional offices / channels; Drive closures of pending cases through active follow ups with branch / divisional offices and TPAs Review and validate TPA invoices, obtain payment approvals and coordinate with Accounts for processing payments; Ensure all payments are disbursed accurately and on time Establish, set-up and revise SOPs, checklists and scripts for tele / video calling processes (e.g. underwriting / fraud detection, medical test feedback, grievance, renewals, agent verification) Collate cases from Underwriting team and plan work allocations to effectively manage tele / video calling volumes Allocate cases and share case data dumps to team members for various calling processes (e.g. underwriting / fraud detection, very high risk, medical test feedback, grievance, agent verification) Ensure completion of daily calls and updation of forms / questionnaires in adherence to SOPs and defined timelines; Conduct random audits / checks to monitor quality and effectiveness of tele / video calls conducted by team Report and discuss negative findings / fraud cases with Underwriting team; Analyse fraud cases to identify common patterns / trends and provide inputs for revising underwriting norms & guidelines Ensure MIS and reports (e.g. medical pendency, case status trackers, TPA adherence to TAT etc.) are prepared and circulated to internal and external stakeholders (e.g. branches / divisional offices / channels / TPAs) as per prescribed formats and timelines Perform data analytics and mining to generate insights regarding risk factors, negative locations, DC feedback etc.; Report and discuss findings with Manger to take appropriate preventive actions to mitigate SLICs risks Coordinate with the IT team for new system / module developments, change / enhancement requests and UATs pertaining to the Underwriting function Provide data support for all audits (internal, IRDA) and respond to all audit queries and clarifications raised Set clear expectations by communicating Tele / Video calling objectives, guidelines, SOPs and timelines to team members. Review performance of team members and provide on-going feedback Train the team on conducting effective tele / video calls, identifying & detecting frauds etc.; Provide guidance to team on specific cases, queries and escalations
Description : Sr. Manager - New Business Operations
Position : In charge New Business Operations
Designation : Sr. Manager
Department : / Vertical : New Business
Location : HO
Reporting Manager : Head - New Business Operations
Direct Reports :
Deputy Manager, Executives (Team Size : 3 to 4)
Role Summary : Purpose :
- Candidate will be responsible for working with medical TPAs to execute medical testing operations for SLIC. The role holder is also responsible for managing tele / video calling operations for the Underwriting function for underwriting / fraud detection, medical test feedback, grievance, agent verification etc.
- Supervising the tele / video calling team is a crucial responsibility. The role holder must also ensure that MIS & reports for relevant stakeholders are published as per prescribed formats & timelines. Process of medical registrations across all center processing, digitizing the process, along with that standardization of New business processing and other operational activities.
Role in any discipline (Operations / Business Management)
Experience Range : 5 to 8 years
Professional Experience / Skills :
Key Responsibilities :
TPA Management
Manage Tele / Video Underwriting Operations
MIS, Reports & Data Analytics
Support IT Projects & Audits
Team Management
(ref : iimjobs.com)
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Manager Insurance • Hyderabad, India
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