2.0 - 5.0 years

4 - 9 Lacs

pune, bengaluru

Work from Office

Process and review Life insurance claims, ensuring adherence to company policies and guidelines. Verify claim documentation, including Death certificate , Employment details, medical records to rule out cause of death and co-morbidities, PMR, FIR , and other supporting documents. Examine insurance applications and documents to ensure accuracy. Communicate with claimants to obtain necessary information and explain the claim process. Assess the validity and coverage of claims, determining eligibility for reimbursement or settlement. Collaborate with claimants, insurance agents, and medical professionals to gather necessary information and resolve any claim-related queries or issues. Keep claim files organized, documenting all actions and decisions. Decision-Making: Determine claim payouts by verifying coverage and assessing the insurance policy. Collaborate with internal teams, such as underwriters and legal departments, to evaluate complex claims and ensure compliance with regulatory requirements. Keep up-to-date with insurance industry trends, policies, and regulations related to Life insurance claims. Requirements: DOCTORS Preferable. Degree in BMS/BAHMS/MBBS, etc (medical background) Previous experience in Life claims processing or a similar role within the insurance industry. In-depth knowledge of insurance principles, policies, and procedures, specifically related to Life Term insurance. Strong understanding of Life claim processing and settlement methodologies. Excellent analytical and problem-solving skills, with the ability to make sound decisions regarding claim eligibility and coverage. Attention to detail and accuracy in reviewing and processing claim documentation. Exceptional communication skills to interact effectively with claimants, insurance agents, and internal stakeholders. Proficient in using relevant software applications and tools for claim processing and record-keeping. Ability to work independently, manage multiple tasks, and prioritize workload effectively. Familiarity with regulatory guidelines and compliance requirements related to Life insurance claims. In addition to the above requirements, as an executive-level profile, the ideal candidate should also possess: Leadership skills to oversee and mentor a team of claims processors. Proven experience in managing and optimizing claims processing workflows. Strong problem-solving and decision-making abilities, particularly in complex or high-value claim scenarios. Excellent interpersonal skills to collaborate with senior management, stakeholders, and external partners. Demonstrated ability to analyse data, generate reports, and present findings to senior executives. Knowledge of strategic planning and business development concepts within the insurance industry.

Posted 11 hours ago

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