We are hiring EB Claims Executive

Job Responsibilities:

***ONLY BHMS GRADUATES CAN APPLY.***

• Having experience (at least 5 yrs) in TPA claim processing.
• Having a Good relationship with Hospitals under the East Zone.

Financial

• Contribute to renewal portfolio expansion through

relationship building with the insurance companies and surveyors to ensure optimum claim settlement in minimum time

During processing of claim analyse the following and communicate to underwriters:

• adequacy of sum insured
• anomalies in the policy
• scope of additional policies
• other related information
• Control expenses

Business Process

• Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following:
• Obtain complete information on the loss from the client after initial intimation
• Submit intimation to the insurance company for

Registration of claim

Allocation of a surveyor

• Obtain LOR (List of Requirements) from the Surveyor
• Match LOR with the Salasar requirement already taken from the client and take rest of the documents
• Once documents are received, check exclusions in fine print and prepare the draft reply from client submitted to insurance company
• Follow up with client for repair and reinstatement for early completion and help in documentation of estimate, contractor details, expenses etc. so that surveyor gets structured inputs for preparation of the survey report
• Follow up with surveyor for completion of assessment
• Communicate surveyors comments to client in terms of estimate and exclusion and arrange meeting between surveyor and client to resolve differences to obtain client assessment
• Ensure surveyors report is submitted at the earliest
• Follow up with insurance company for early settlement of claim
• Obtain settlement voucher from insurance company and forward to client
• Get discharge of client (signoff) and submit to insurance company for disbursement
• Update each step in SAIBA on real time basis and ensure due IRDA compliance
• Ensure resolution of all complex technical issues in claims and timely escalation of the same for quick disposal of the claim

Customer

• Support the marketing department in obtaining new business and ensuring best possible coverage for client, talk to technical dept of client to understand which risks need to be covered, type of production (continuous/ batch)
• Reopen claims in case of new businesses and follow up to obtain claims after reopening of file by insurance company if repudiation is not time-barred
• Participate in fortnightly meetings to give updates to the business development and client servicing teams on the status of claims in order that they are updated about the same before meeting client for renewals
• Interface with clients to reinforce relationship with existing clients
• Prepare and submit daily / monthly reports on status of claims

People Growth

• Acquire product knowledge and always keep self updated with latest variations in product offerings
• Attend training sessions (external/ internal) and working on on-job assignments to implement new learning
• Conduct training sessions for marketing team as well underwriting and claims teams to build product knowledge across functions
• Set objectives, review and evaluate performance periodically and give feedback
• Review pending work and initiate action

Perform all such duties which are required to be performed by this position in an insurance broking house in general course and to perform all such duties and carry out all such responsibilities so delegated or asked to be performed by the Designated Authority from time to time

External Interface:

Internal interface:

• Existing clients
• Prospective clients
• Insurance companies
• Employees

Preferred Competencies

a)

Demonstrates domain knowledge in own area of operation

Understands product offerings

Understands service standards as per the Organization's ethos

Learns continuously and keeps self-updated

b ) Leadership Competencies

Relationship Building

Networks effectively with both external and internal customers

Focuses on building long-term, sustainable relationships

Delivers on commitment every time

Creative & Analytical Problem Solving

Understands the strategic objectives of the Organization, unit, and function

Collates data and analyses them objectively

Takes objective decisions based on data to achieve the strategic objective of the Organization

Goes the extra mile to achieve creative solutions

Customer Focus

Designs solutions that meet the requirements of the customer (external/ internal)

Demonstrates a sense of urgency to resolve all external and internal customer concerns and responds to queries and requests within defined timelines and processes

Educates customers (external/ internal) about changes in processes, policies and offerings

Creates long term relationships with customers (external/ internal) through continuous interface

Obtains customer (external/ internal) feedback to improve processes

Promotes loyalty and converts customers to brand ambassadors

Achieves customer delight concerning both internal and external customers

Is sensitive to the code of conduct in the office and customer establishments

Perseverance

Makes every possible effort to understand the viewpoints of external and internal customers

Takes all possible steps to resolve issues

Understands the importance of deadlines, proactively removes roadblocks, and delivers as per requirement

Tries alternatives to achieve the target

Does not give up in the face of adversity

Explains own point of view assertively to get necessary support and approval

Is patient and persistent towards follow-up on all leads and prospects generated during the past, towards new client acquisition

Achievement Orientation

Understands the strategic objectives of the Organisation, unit, and function

Aligns individual and team targets with strategic goals

Plan and deploy appropriate resources to meet targets in the short and long term

Goes the extra mile to achieve targets as per committed timelines and enables the team to do so

Achieves and motivates excellence irrespective of circumstances

Shares best practices across businesses

Benchmarks with the best and continuously raise the bar

Upgrades competencies of self and team to achieve excellence

susweta@salasarserviecs.com