Job Details
Business Ficial Service HO
Unit Aditya Birla Health Insurance Company Ltd
Location Thane
Reports to Poornata Position Number
Position Title Assistant/Deputy Manager Claims
Reports to (Position Title) Manager/ Sr. Manager
Function Services Operations
Department Claims
Designation of the Employee Assistant/Deputy Manager
Designation of the Manager Manager/ Sr. Manager
Date of writing/updation of JD 08.01.2024
Job Purpose

The purpose of this role includes ensuring coordination with the Service provider partner team for timely settlement of Travel and OPD claims. Candidate should be able to do regular medical and technical audits of the claims approved for settlement by the partner and should be able to maintain the MIS/Reports related to claims.
Dimensions
Business Workforce Number On Roll 6000+
Business Workforce Number Offroll/ Part time 4000+
Unit Workforce Number On Roll 6000
Unit Workforce Number Offroll/ Part time 4000+
Function Workforce Number On Roll 800
Function Workforce Number Offroll/ Part time 279




Department Workforce Number On Roll 69
Department Workforce Number Offroll/ Part time 66
Other Quantitative and Significant Parameters for the job: Budgets/ Volumes/No. of Products/Geography/ Markets/ Customers or any other parameter
Job Context & Major Challenges

To ensure Quality in the claim process and audit, managing TAT as per agreed SLA
Key Result Areas

Key Result Areas (Max 1325 Characters)

Supporting Actions (Max 1325 Characters)
Accurate and timely submission of periodic and adhoc reports related to Claims
Develop, Implement shortcuts, formulae on excel, using alternative tools/methods for timely submission
Do cursory/sanity checks before submission
Closure of audit observations
Trainings to the partner claim processors regarding policy T&C; s, Time management, Delegation
Robust coordination skills with other departments, sharp and on the spot thinking, proactive approach, soft skills, ex

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