Associate Vice President - Health Management

ICICI Lombard

9 - 14 years

17 - 25 Lacs

hyderabad

Posted:1 day ago| Platform:

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Skills Required

health claims cashless claims processing health insurance team handling general insurance health indemnity claims life insurance claims ratio claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Strong knowledge of Health Insurance and products
Must have a minimum of 10 years experience in health claims management with over 5 years managerial experience.
The candidate can be from health insurance, general insurance, reinsurance, or life insurance industries.
Extensive experience in health claims processing and administration.
Proficient in health claim fraud prevention & loss mitigation framework.
Should have experience in managing large teams
Understanding of Health Claims and claim related processes
Lead a team handling claims, customer queries & complaints, risk & Loss mitigation team , Implement & monitor framework designed.
Drive health claims policy formulation and optimizing the processes for the function.
Supervision and medical review of high loss health indemnity claims
Formulate & ensure faster claims settlement with superior TAT & customer experience.
Analyze incurred claims ratio, review of portfolio, and take proactive action for loss control measures.
Stay up to date on amendments and provisions in health insurance regulations & implement changes in claims processes to ensure compliance.
Conduct Medical data analytics, reporting for the stakeholders like (department head, management committee, regulator, IIB etc.) on defined intervals.
Train & develop medical processors. Identify key learnings, gaps, and opportunities for individuals to develop the team.
Build & maintain a relationship with external service partners including but not limited to Sales channel partners, Hospitals etc

Preferred candidate profile

MBBS/BHMS/BAMS and MBA Hospital Administration
MBA in Hospital Management / Insurance / Fellow from Insurance Institute of India, Six Sigma Green/ Black belt

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