Cluster Manager - Health Investigation

Bajaj Allianz Life Insurance

New Delhi

Not disclosed

Work from Office

Full Time

Min. 2 years

Job Details

Job Description

Cluster Manager - ILM - Health

Description

Desktop Investigation

  • Trigger identification through data at intimation/Referral stage
  • Social media searches
  • Cold calling using digital platforms
  • Identify key business people, link analysis

 

Claim Investigation

  • Allocation of assigned claims to respective vendors with case relevant triggers
  • Follow up for IR and TAT management
  • Level 1 QC clearance & validate the submissions against shared triggers
  • Success in claim investigation based upon strong medical & legal evidences
  • Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing & creating evidence which stands in court of law
  • Report submission and coordination with claims team.

 

Evidence Matrix Assurance

  • Ascertain evidence quality as per matrix
  • Validate each & every evidence with the case triggers
  • DMS of hardcopy maintenance

 

Escalation Management

  • Document Complaince through Field Investigation of HVC
  • Further Requirement Complaince
  • OFR and CFR with Stake holders

 

Data Management

  • MIS preparation and report reconciliation
  • Payment reconciliation with Vendors
  • Project tracking

Skills Required

Health Investigation,

Education/Qualification

BAMS/BHMS

Desirable Skills

None

Job role

Work location

Delhi HUB

Department

Healthcare / Doctor / Hospital Staff

Role / Category

Hospital Admin

Employment type

Full Time

Shift

Day Shift

Job requirements

Experience

Min. 2 years

About company

Name

Bajaj Allianz Life Insurance

Job posted by Bajaj Allianz Life Insurance

This job has expired