Role & responsibilities:

- Maintaining, tracking, and analyzing claim savings, high-value claims, pending queries, dependencies, and other operational data.
- Analyze key claims performance metrics, including approval ratio, denial trends, turnaround time (TAT), and claim volumes.
- End to end operations for cashless claim file health insurance
- Coordinate with the Provider Management, Provider Audit, Special Investigation Unit (SIU), Fraud Management, and other cross-functional teams to ensure smooth and efficient claim processing.
- Manage escalated claims involving hospitals, healthcare providers, producers, and internal Provider Management teams to ensure timely resolution.
- Allocation of Reimbursement claims from Supervisor role based on ageing and claim amount.

Preferred candidate profile:

- MBA/PGDM degree is required
- Positive communication skills are must
- Advanced excel knowledge is required
- Candidates who also have knowledge of SQL and Power Bi will be preferred
- Candidates must be okay with rotational shifts and flexible week-offs (please note overnight shifts are not there, we have late night shifts)

📌 MBA Hiring | Manager - Health Claims (Claims MIS & Operations Analyst) (Uttar Pradesh)
🏢 TATA AIG General Insurance Company
📍 Uttar Pradesh