Basic Details: Fill the required information about business, unit, location, position, reports to position and date of updation of JD

Business

Financial Service - HO

Unit

Aditya Birla Health Insurance Company Ltd

Location

Thane

Poornata Position Number of the job

Reports to: Poornata Position Number

Poornata Position Title of the job (30 characters max)

AM/DM

Reports to: Poornata Position Title

Manager

Function

Services Operations

Reports to: Function

Services Operations

Department

Ops - FWA

Reports to: Department

Ops - FWA

Designation of the Employee

Manager – Ops- FWA

Designation of the Manager

Zonal / Central Manager – Ops - FWA

Date of writing/updation of JD

22 nd March 2024

Job Purpose: Write the purpose for which the job exists (in 2-3 lines) (Max 1325 Characters)

The purpose of this role includes

To do investigation of the cases referred to FWA team,



do the quality check of cases referred to investigation and at additional observation point for investigation allocate case to vendor in a given TAT and take follow up with vendor to cover 3- 5 parameter along with supporting investigation documents which will help in taking final decision on claim. Payable/rejection, query).

FWA manager need to also monitor closely to vendor on quality of investigation, parameters covered during investigation, evidences collected during investigation. Adherence to investigation TAT, vendor involvement with nexus are giving wrong report. In branch level they also need to observe FLS, local hospitals, vendors, customers, sales manager, provider manager involved in any fraudulent activity and same need to be reported to zonal manager and vertical manager.

Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job.

Business Workforce Number

(Max 254 Characters)

On Roll – 6000+

Offroll/ Part time – 4000+

Unit Workforce Number

(Max 254 Characters)

On

📌 DM-PN(Trivandrum) (India)
🏢 Aditya Birla Health Insurance Company
📍 India