Skills &amp; Qualification

<ul>
<li>Strong knowledge of health insurance and claims investigation processes</li>
</ul>

<ul>
<li>Excellent communication and interpersonal skills to effectively manage vendors and stakeholders</li>
</ul>

<ul>
<li>Ability to analyze data and identify trends to improve investigation processes</li>
</ul>

<ul>
<li>Strong problem-solving skills to resolve complex claims investigations</li>
</ul>

<ul>
<li>Ability to work efficiently under pressure and meet deadlines</li>
</ul>

<ul>
<li>Proficient in Microsoft Office Suite, particularly Excel, Word, and PowerPoint</li>
</ul>

<ul>
<li>Strong leadership and management skills to effectively manage a team</li>
</ul>

<ul>
<li>Ability to travel to carry out field investigations</li>
</ul>

Responsibilities

<ul>
<li>Follow the Standard Operating Procedure (SOP) laid out for Health Claims Investigations</li>
</ul>

<ul>
<li>Takes full responsibility of managing health claims investigations, including allocation of cases to external vendors, follow-up for reports, and quality control of investigation reports</li>
</ul>

<ul>
<li>Will be willing to travel to carry out field investigations</li>
</ul>

<ul>
<li>Ensures to get the investigation reports within the prescribed Turn-Around-Time (TAT)</li>
</ul>

<ul>
<li>Maintains the quality of investigation reports from vendors by conducting regular quality checks</li>
</ul>

<ul>
<li>Provides proactive assistance to the Health Claims team to achieve customer delight and high-level customer satisfaction for the insured and internal stakeholders</li>
</ul>

<ul>
<li>Works efficiently to meet set goals and avoids any escalations to maintain relevance and quality while providing service to stakeholders</li>
</ul>

<ul>
<li>Handles vendor management, including obtaining SLAs and documents for empanelment</li>
</ul>

<ul>
<li>Handles projects and additional tasks assigned</li>
</ul>

Claims Manager

Skills &amp; Qualification Strong knowledge of health insurance and claims investigation processes Excellent communication and interpersonal skills to effectively manage vendors and stakeholders Ability to analyze data and identify trends to improve investigation processes Strong problem-solving skills to resolve complex claims investigations Ability to work efficiently under pressure and meet deadlines Proficient in Microsoft Office Suite, particularly Excel, Word, and PowerPoint Strong leadership and management skills to effectively manage a team Ability to travel to carry out field investigations Responsibilities Follow the Standard Operating Procedure (SOP) laid out for Health Claims Investigations Takes full responsibility of managing health claims investigations, including allocation of cases to external vendors, follow-up for reports, and quality control of investigation reports Will be willing to travel to carry out field investigations Ensures to get the investigation reports within the prescribed Turn-Around-Time (TAT) Maintains the quality of investigation reports from vendors by conducting regular quality checks Provides proactive assistance to the Health Claims team to achieve customer delight and high-level customer satisfaction for the insured and internal stakeholders Works efficiently to meet set goals and avoids any escalations to maintain relevance and quality while providing service to stakeholders Handles vendor management, including obtaining SLAs and documents for empanelment Handles projects and additional tasks assigned

Claims Manager in Bengaluru (UID-14129)

Job Description

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Skills Required for Claims Manager

Job Description for Claims Manager

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