Job Purpose
The purpose of this role includes Ensuring processing of claims on daily basis, ensuring control & Reporting to stake holders, Month End Closing related Activity, Statutory and Internal Audits, Identification of system issues and follow up with IT for closure. IT Spoc for Business Requirement from Insurance Accounting point of viewPreparation of Balance Sheet GL Schedules and closure of Open itemsJob Context & Major Challenges
Job Context/ Job Challenges
About the Health Insurance Industry -While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business.Market Opportunities - With the advent of medical advancements, lifestyle changes, change in Indian socio-economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.About The Aditya Birla Health Insurance -
Aditya Birla Health Insurance Co. Limited (ABHICL) was incorporated in 2015 as a 51:49 joint venture between Aditya Birla Capital Limited (ABCL) and MMI Strategic Investments (Pty) Ltd. ABHICL commenced its operations in October 2016.ABHICL has entered the competitive health insurance market with an aim to expand the category to wider customer segments, beyond the ones that health insurance companies traditionally have marketed to. As the 6th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itself though the unique business proposition of Health Insurance for All, a one of a kind proposition in India at the moment. This is a philosophy that is being built through every single consumer touch point and into every single backend process of the company to ensure a customers experience of our proposition is continuous and seamless.ABHIs unique offering to market includes proposition includes -A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthyA Chronic Care Management Program to cater to the unmet needs of a growing Indian population of those suffering from chronic lifestyle conditions like Diabetes, Asthma, High Cholesterol and Hypertension from Day 1ABHICL serves as an enabler and influencer of health and healthcare choices that customers make, in addition to being a payer of healthcare expenses. Thus, ABHICL would act like a much needed catalyst to grow the prevalent health insurance landscape in India through product innovations and a wider choice of consumer relevant products.ABHICLs vision has always been digital. The company has been successful in adopting paper-less approach right from identifying to on-boarding to delivering seamless experience of its customers & employees.Challenges -Claims payment on regular basisEnsuring control environment of transactions are effectiveEnsuring daily processing controlEnsuring monthly GL Recon on timely basisIdentifying gap & discussion for closureGap analysis in process and working on improvementMonthly / Quarterly / Annual Closing - Ensuring closing process and accounting on timely basisKey Result Areas
KRA (Accountabilities) (Max 1325 Characters)
Supporting Actions (Max 1325 Characters)
KRA1 Ensuring processing of claims on daily basis, ensuring control & Reporting to stake holders Processing of Claims payment on daily basis and ensuring no wrong/double paymentSharing the payment advice to claims team/customerPutting all control checks to ensure no error in payment fileTimely closure of accounting entry on daily basisAnalysing the system issues and co-ordinate with IT for rectification, if anyPrepare and keep the updated register to ensure accuracy over payment and reportingCoordination with Claims team ensure their requirement are metSharing the daily/weekly/monthly reporting all stakeholderKRA2 Month End Closing related Activity Coordination of Claims register and ensuring the completeness and accuracy of dataPreparation of monthly accounting entries and matching with the payment file and recon with ITD registerDoing the claims expense analysis and sharing with all stakeholderChecking all Audit related points in claims register and ensure no Audit issues are repeatedTechnical / operational accounting and reconciliation.KRA3 Preparation of Balance Sheet GL Schedules and closure of Open items Schedule preparation of Claims ReserveIRDAI Reporting tracker and Unclaimed payment and schedule preparationEnsuring daily recon in place to avoid any long pending open itemRegular follow-up with concern stakeholder for open item & timely closer of open itemsKRA4 Statutory and Internal Audits Handling statutory and internal Audits related to above areas and ensure minimum issues/observation
