Cluster Manager - ILM -Health

4 - 8 years

6 - 10 Lacs

Posted:1 week ago| Platform: Naukri logo

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Work Mode

Work from Office

Job Type

Full Time

Job Description

Desktop Investigation Trigger identification through data at intimation/Referral stage Social media searches Cold calling using digital platforms Identify key business people, link analysis Claim Investigation Allocation of assigned claims to respective vendors with case relevant triggers Follow up for IR and TAT management Level 1 QC clearance validate the submissions against shared triggers Success in claim investigation based upon strong medical legal evidences Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing creating evidence which stands in court of law Report submission and coordination with claims team. Evidence Matrix Assurance Ascertain evidence quality as per matrix Validate each every evidence with the case triggers DMS of hardcopy maintenance Escalation Management Document Complaince through Field Investigation of HVC Further Requirement Complaince OFR and CFR with Stake holders Data Management MIS preparation and report reconciliation Payment reconciliation with Vendors Project tracking Vendor Management Vendor Empanelment Training Development Ensure the ethics and compliance during managing the external investigators and self- investigation of cases Vendor Payment Reconciliation

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Bajaj Allianz General Insurance
Bajaj Allianz General Insurance

Insurance

Pune Maharastra

5001-10000 Employees

891 Jobs

    Key People

  • Tushar Kumar

    MD & CEO
  • Rohit Ghosh

    Chief Financial Officer

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