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Senior Manager Health Claims

TATA AIG General Insurance Company Limited
Noida, UP, IN
2ds ago0 view0 clicked apply
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  • Lead and manage a team of Non-Medical Claims Adjudicators handling Cashless and Reimbursement health insurance claims.
  • Ensure timely and accurate adjudication of claims in accordance with policy terms, company guidelines, and regulatory requirements.
  • Monitor daily claim inventories, workload distribution, and claim pendency to ensure efficient operations.
  • Supervise and review the performance of team members, providing regular coaching, feedback, and support.
  • Conduct supervisor audits of processed claims to ensure adherence to quality standards and operational procedures.
  • Oversee the activities of the DEO and Inward teams, ensuring accuracy and timely completion of assigned tasks.
  • Review and analyze daily operational reports related to claim processing, productivity, quality, and turnaround times.
  • Handle escalated cases and coordinate with internal stakeholders for effective resolution of issues.
  • Ensure error-free data capture and maintain high standards of quality across the claims processing lifecycle.
  • Drive process improvement initiatives to enhance operational efficiency and customer experience.
  • Promote the use of digital tools and technologies, including OCR-based processing, to improve automation and productivity.
  • Identify training needs and facilitate skill development programs for team members.
  • Support compliance, audit, and risk management requirements by ensuring adherence to established processes and controls.
  • Prepare management reports and provide insights on team performance, operational trends, and improvement opportunities.
  • Foster a collaborative, high-performance work environment focused on service excellence and continuous improvement.
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