Senior Manager

Data reporting to Insurer authorities, Corporates, Brokers and TPA management. May13- till date Data interpretation, claim analytics, Fraud analytics, Loss and reserve analytics, trends, recommendations on the policy behavior are the key focused areas Publishing detailed analysis of specific corporate with respect to historical data available. Utilization patterns with respect to age, gender, Sum insured, relation, Location etc., Analyzing CTQs such as Average claim value, TAT, Morbidity ratio, Loss ratio etc. Impact analysis of implied disease sub limits, co-payments, room limits, savings etc. TAT reports: Establishes the FIFO movement of claims and the compliance of service delivery to customer will be justified. Fraud Analytics: Investigation referral ratio, Success ratio and savings will be published. Suggestions on Loss control measures Discussing and exploring the trends in the policy with inferences supported by facts. Publishing organization level business portfolio dashboards with information on servicing premium, policies, lives, fee etc., Business proposal documentation. Hospital Dashboards: Volumes, Region wise top hospitals, Ageing of Claim file pending preauth approvals, payment TATs, Early payment discount listings, Package utilizations Vs Open billing cases, Medical management Vs Surgical Cases etc. Gathering Client requirements Analyzing the sufficiency of existing system architecture to meet the client requirement. Coordinating with IT and Database teams for development of new requirements as per business needs. Identifying key functionalities required for ‘Process’ with respect to systems under operation. Suggesting the possible improvements at system level to IT team for better customer service and for better business management. MIS reporting web logins architecture as per the client expectations and as well enchanting in visualization. Documenting the testing scenarios and sign off confirmations. Training to the clients (if required) post implementation phase. Updating the client on timelines and status of developments on timely basis. Resolving issues on period basis as and when required. Team Handling Responsibilities: Work distribution Profile allocation Collation of Output Deriving KPI Planning of new strategies to overcome difficulties and as well to enhance the customer satisfaction Establishing compliance of reports delivery to the right customer at right time with accuracy (both internal and external).