Executive HAT Care Unit-HAT Coordinators

Job Description

1. Claims Administration and Management Coordinate with branches in resolving the claims within the set SLAs / TATs; resolve any issue / concern Review the claim settlement status daily; guide team in addressing claims which exceed TAT; seek clarifications and resolve issues to ensure that the claims are processed at the earliest Conduct reviews (OFR / CFR) to identify problems within claims settlement and propose solutions; discuss the same with the superior and seek feedback / assistance in the same 2. TPA Management Connect with the TPA vendors and invite quotes; assess information like loss ratio/ service expectations, etc. ; Negotiate with the TPAs on different aspects; assess loss ratio and drive action to arrest the same by seeking assistance from underwriting team on premium / risk assessment, etc. Share policy details, benefits and nuances; train them on the specifics of the policy and how to administer the payment / claim processing 3. Report Generation (MIS) Generate MIS on set frequency and apprise relevant stakeholder of the claim status within the team Provide clarifications / reasons in case of delayed claim settlement 4. Team Training Lead training efforts for upskilling of team to better deliver in terms of claims administration, settlement, issue resolution, etc. Provide directions in planning and coordination of training efforts for team Motivate and retain key talent in the team 5. Process Improvement Collaborate with technology teams internally to drive implementation of tech-based platforms for claims processing, etc. Support different internal teams to come up with innovations / process improvement and drive its implementation for effective claims management 6. Team Development and Engagement Establish location wise performance expectations and evaluation metrics, and regularly review location wise performance Share information regarding business and key developments with the team proactively; guide them in utilizing their skills in the best possible manner Understand team grievances and guide for their effective resolution Identify and create development opportunities for team members to enhance functional knowledge