Job Summary

The purpose of this role is to plan, establish and supervise the MIS function of Claims. This includes ensuring accurate and timely submission of periodic and adhoc reports related to Claims to the Regulatory Authority, handling Audits (IRDA, internal audits and other audits), preparing the claims register, bring in process improvements, automation, publishing analytical reports / Claims MIS and daily dashboard.

The purpose involves Data Support and interdepartment coordination with all stakeholders including sales, fice, internal claims and actuary teams.
Dimensions
- Business Workforce Number (Max 254 Characters): 6
- Other Quantitative and Significant Parameters for the job: Budgets/ Volumes/No. of Products/Geography/ Markets/ Customers or any other parameter
- Prepare and Publish Claims MIS
Responsibilities
- Regulatory Submissions: Accurate and timely submission of periodic and adhoc reports related to Claims to the Regulatory Authority/GI Council
- Handling Audits (IRDA, internal audits)
- Complete ownership of handling all audits in the Claims function IRDA, Internal,



Statutory, Concurrent and Retrospective
- Data submission/query response/adhoc reports to IRDA/GI Council
- Ensure proper closure of audit observations
- Publish Dashboards
- Claims TATs: Cashless, Reimbursement in house TPA periodically
- Analytics Claims trends and Apprise/Alert the relevant stakeholders
- Publish Daily/weekly/monthly dashboards related to Claims Intimations, TAT, NPS, Settlement Ratio, Average Claim size, Productivity, Pendency, Digital metrics
- Monthly / Quarterly / Annual Data submission
- Coordination Interdepartmental/within the department
- With internal/external stakeholders including Sales, Fice, Actuary, Underwriting, FWA Internal claims team Cashless, Reimbursement, Grievances, Group, Customer Care Team
Metrics
- Metric: PBT before Holdco expenses
- Units: Rs Mn
- FY18B: 1,709
- FY19: 2,021
- FY20: 1,628
Job Context: Major Challenges

About the Health In

📌 Lead - Claims (Thane)
🏢 Aditya Birla Insulators
📍 Thane