Manage and lead a team of claims specialists, providing guidance, mentorship, and support to ensure exceptional customer service and efficient claims processing. Oversee the end-to-end claims process, from initial claim submission to resolution, ensuring accuracy, compliance, and timely processing. Implement and maintain quality control measures to uphold the highest standards of claims handling Interact with policyholders, agents and other stakeholders to address claim related inquiries and concerns. Utilize claims data and analytics to identify trends, patterns and opportunities for process improvement. Ensure compliance with insurance regulations and company policies in all claims processing activities. Monitor and report on departmental performance metrics, including claims processing times, customer satisfaction and efficiency. Identify and implement process enhancements to streamline claims operations and enhance the customer experience. Provide training and development opportunities for team members to enhance their skills and knowledge.
Role & responsibilities Building and Managing positive relationships with the Hospitals. Researching and generating new business with the hospitals. Doing Empanelment of Hospitals. Help promote and maintain a positive company image. If required, he/she should accompany any VIP patient who is getting admitted to the hospital.