Job openings for Claims Manager in Mumbai Thane

Job profile:
• Accurate and timely submission of periodic and ad-hoc reports related to Claims
Trainings to the partner claim processors regarding policy T&C’s, Time management, Delegation
• Debit note supervision for all the payments from TPA’s & OPD Partners Viz.
• Coordinating with Partner leadership teams /tech teams for MVP implementations viz
• In health check-ups utilization should be driven towards home collection instead of hospitals.
• FWA investigations are to be conducted in the agreed percentage of claims. (Partner end)
• The reimbursement claims adjudication rule engine (automated) should be aligned with the company process
• Real time client Dashboard for client reviews.
• Query management
• Medicos to process OPD claims
• Maintain daily MIS
Technical skills: Reimbursement claims, MIS , Insurance, health insurance, medical insurance
Soft skills: Good communication skills, leadership skills, interpersonal skills, analytical skills, , interpersonal skills
Educational Qualification: Any Graduate
Experience: 2 or more years of relevant experience in insurance or third party administrator