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APosition Overview
Position Title | Assistant Manager- Underwriting |
Department | Operations Underwriting |
Level / Band | 301 |
Role Summary:
.Responsible for Health claim processing (including End to End processing of claims)
.Expertise in reviewing claim documents, medical opinions and understanding policy terms and conditions
.Risk assessment and triggering verification of suspicious claims
.Should be able to coordinate with FIU team, sales team, product team, legal team, complaints team, vendors etc for claims processing, escalations & litigation cases etc.
BOrganizational Relationships
Reports To | Senior Manager |
Supervises | NA |
CJob Dimensions
Geographic Area Covered | Pan India |
StakeholdersInternal | FIU team, sales team, product team, legal team, complaints team |
External | Customer/ Policyholder, Vendor- Prorisk/ Medi Assist |
DKey Result Areas
Organization Process | Key Contribution |
To ensure quality & accuracy of Health Claim processes | .Good knowledge on insurance & products & ability to take claim decisions as per policy terms and conditions .Ensure 100% quality completion of Claim decision .Ensure all cases are received by the department as per the specified inter & intra department SLAs. .Presenting case summary and representing to reinsurers, communicating with distribution stakeholders .Ensure adherence to defined claims TAT & decision accuracy .Mentor, guide & train new team members .Ensure quality & accuracy of Claims process .Sharing feedback and conducting meetings with the relevant stakeholder's time to time .Evaluate emerging trends, competition practices and propose recommendations to senior management |
ESkills Required
Technical | .Medical background- Education - minimum BAMS /BHMS/ BDS .Experience - insurance experience, life + Health UW/claims .Effective presentation and interpersonal skills. .Good system skills in Excel/Word. .Multitasking |
Behavioral | Essential | Desired |
Analytical & Excel Skills | . | |
Communication skills | . | |
Supervising/Leadership skills | ||
Teamwork Skills | . | |
Influencing skills | ||
Relationship Building skills | . | |
Decision making skills | . |
FIncumbent Characteristics
Essential | |
Qualification | Doctor |
Experience | 5-8 years of experience in Health claim processing |
Date Posted: 13/11/2024
Job ID: 100221397
ata AIA Life Insurance Company Limited (Tata AIA Life Insurance) is a joint venture company, formed by Tata Sons Pvt. Ltd. and AIA Group Ltd. (AIA). Tata AIA Life Insurance combines Tata’s preeminent leadership position in India and AIA’s presence as the largest, independent listed pan-Asian life insurance group in the world spanning 18 markets in the Asia Pacific region. Tata AIA Life Insurance is also one of the leading insurers in the Indian private sector.
