Role Overview

To deliver high-quality customer service by resolving queries and service requests, ensuring accurate claims processing, and strengthening customer satisfaction through effective coordination with TPAs, insurers, and internal teams.

Reporting Structure:

Reports to: Executive > Team Lead > Assistant Manager > Manager

Principal Accountabilities:
- Resolve Customer Queries: Provide first-level support and close 90% of customer queries at the first point of contact.
- Claims Guidance: Ensure 100% accuracy in guiding customers through claims submission, with zero document rejections.
- Issue Resolution: Coordinate with TPAs, insurers, and internal teams to resolve 95% of issues within defined SLA timelines.
- Record Management: Maintain up-to-date and error-free records of all interactions, claims, and escalations.
- Customer Relationship: Achieve at least 85% customer satisfaction ratings through proactive relationship management.

Major Challenges
- Managing high call volumes while maintaining SLA compliance.




- Coordinating across multiple stakeholders to ensure timely resolution.
- Handling customer escalations with professionalism and accuracy.

Decisions
- Make independent decisions on standard customer queries and claims.
- Escalate complex or policy-related issues to the appropriate authority.

Interactions
- Internal: Operations, Claims, IT Support, Finance.
- External: TPAs, Insurance Companies, Customers.

Dimensions
- Service Requests Handled per Day: [Numbers].
- Average Resolution SLA: [TAT, 24–48 hours].
- Customer Satisfaction Target: ≥ 95%.

Skills & Knowledge
- Minimum Qualification: Graduation.
- Robust communication and relationship management skills.
- Knowledge of TPA/Insurance processes (preferred).
- Problem-solving and coordination skills.
- Excel proficiency (mandatory for Team Lead role).

Experience
- Executive: Freshers to 3 years of experience.
- Team Lead: 3+ years of experience with proven Excel and reporting skills.

📌 MIS Executive (Chennai)
🏢 Vidal Health Insurance TPA
📍 Chennai