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Star Health Insurance
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Senior Manager - Claims

Senior Manager - Claims

Star Health Insurance

0 - 5 years

7 - 8 Lacs

chennai

Posted:2 days ago| Platform:

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Skills Required

accounting system payment processing claims excel investigation outsourcing accounts handling slas

Work Mode

Work from Office

Job Type

Full Time

Job Description

To bear full responsibility for ensuring payments correctly and promptly as per guidance laid down as under :

1. Checking all claims (For new agencies - 3 months) received from PAN INDIA - Outsourced FVOs & Private Investigator Agencies for Payment processing.

2. Checking 20% of claims for old agencies (after 3 months of rendering services).

3. Calculation & Consolidation of PAN INDIA Inhouse FVOs Travel Allowances & PAN INDIA Outsource Professional Fees.

4. Calculation of Payments to PIAs as per SLAs - Excel breakups and getting invoices from Private Vendors.

5. Follow-up for approvals for all IH FVOs, OS FVOs and PIAs Payments.

6. Analysis of Hit rate every quarter and alert to PIAs when low hit rate is noted (as per SLA).

7. Savings mapping for Pan India IH FVOs, OS FVOs & PIAs for payment processing .

8. Private vendor - M/s. Medi probe - Travel Expenses calculation (to be revised). This is a separate assessment at present. The SLA is being revised to include the ground realities and bring in better control over the private vendors. At that time, more uniform accounting system is to be put in place.

9. By the 5th day of every month, Inhouse (Travel allowances) and Outsourced FVOs (Professional fees) payment to be processed and sent to Central Accounts Team.

10. To ensure that GST is paid as per government directions.

11. The no of private agencies in the service of the company for conducting various categories of investigations is proposed to be increased to about 50 from the current 30 numbers. The accounts handling of all these (about 50 private agencies) would be best handled by adopting high tech/ creation of a separate portal which will automatically check the Buddy Claim app and provide information whether the said investigation report is eligible for payment or not.

Hence, the candidate to be appointed is required to be tech savvy also.

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Senior Manager - Claims