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    Manager - Claims - thane, India - Tata AIA Life Insurance

    Tata AIA Life Insurance
    Tata AIA Life Insurance thane, India

    1 day ago

    tata aia life insurance background
    Description

    APosition Overview

    Position Title

    Asst Manager / Manager – Claims

    Department

    Claims

    Level/ Band

    Asst. Manager / Manager

    Role Summary:

  • Responsible for all system enhancements, New Projects.
  • Responsible for PIC (Product Implementation Committee) related activities. To prepare User requirements, Test scopes, Validate Outputs received from UAT team. Train members on New Products, New deployments etc.
  • If required conduct UAT Testings, prepare BRD document
  • Track Pending Day1-Day2 Activities related to new products/Claim processing
  • Responsible for product configuration
  • Responsible for tracking production issues and resolving them.
  • Responsible for identifying Gaps and raising requirement with IT for automation of process.
  • Handling Projects in defined timelines, publishing projects charter, status to higher management.

    • BOrganizational Relationships

    Reports toDirect

    Sr Manager - Claims

    Supervises

    CJob Dimensions

    Geographic Area Covered

    PAN -India

    StakeholdersInternal

    Underwriting team, Zonal Team, IT, POS, CS, Legal & Compliance

    External

    External legal consultant, legal counsel, vendors.

    DKey Result Areas

    System Administration

    ·Responsible in closing all the Open PIR's / Production related issues by Coordinating with allocated vendors.

    ·Raising system related requirement with IT for CR preparation.

    ·Liaise with IT in closing the UAT related to CR's / PIR's and products.

    ·Responsible for PIC (Product Implementation Committee) related activities. To prepare User requirements, Test scopes, Validate Outputs received from UAT team. Train members on New Products, New deployments etc.

    ESkills Required

    Technical

    ·Claims Processing.

    ·Sound knowledge of product contracts.

    ·Knowledge of medical terminologies.

    ·Legal Updates.

    ·Preparation of BRD, Project Management, Product configuration & development

    ·Regulatory guidelines.

    ·Presentation skills.

    ·Communication skill

    F: Competencies-

    Customer & Consumer Engagement

    And Experience in a Hybrid World

    Goes out of the way to deliver on time,

    the commitments made to the

    customers and consumers while

    striking a balance between their

    changing needs and organizational's

    processes. Clearly identifies the full

    range of customers to be served, their

    stated needs and offers options and

    suggestions to match their current

    and future expectations. Works

    towards integrating data, technology

    and strategy into creating hybrid

    customer experience solutions.

    Cultivates a consumer focused

    attitude among colleagues and assists

    team members to focus on various

    touchpoints to achieve customer

    satisfaction. Strives to exceed clients

    expectations by offering various

    possible options to pick and choose

    from which will completely satisfy

    their needs and be in their best

    benefit. Effects changes keeping in

    mind the customer context to deliver

    greater value and satisfaction to the

    customers.

    Business Acumen and

    Domain Knowledge

    Knows how claims are managed based on

    set parameters and authority levels for .

    by class of business, type of claim, below a

    set financial limit etc. Knows how a claim is

    assessed to identify if it requires specialist

    handling and the resultant claims

    management process for . fraud

    suspicions, a large loss etc. Is able to analyze

    past claims data of company, industry trends

    to ensure no malicious attempt is rewarded

    by fraud claimant.

    Knows how claims reserving techniques are

    used and how to assess whether a claim

    reserve is accurate. Is able to drive teams in

    effective utilization of available technology

    and suggest if any upgradation is required in

    systems. Is able to handle litigation forums

    of dissatisfied customers with empathy. Is

    able to understand medical terms and seek

    support wherever required from medical

    practitioners to check authenticity of filed

    claims

    Networking and Collaboration

    Continuously stays in touch with key

    networks and contacts, with an

    objective of leveraging these

    relationships for achieving goals. Is able

    to build relations, communicate and

    collaborate with cross functional team

    members across all levels without

    difficulty to achieve desired results.

    Values team member contributions and

    efforts. Persuades others by sharing

    past experience and presenting

    multiple arguments in order to support

    the discussion / views

    Change Management

    Demonstrates insightful thinking and

    finds innovative solutions to

    challenges within and across

    functions. Proactively initiates change

    to achieve improvements in quality or

    efficiency of work and modifies

    self-behaviour and approach to deal

    with changing scenarios. Explains the

    process, implications and rationale for

    change to those affected by it.

    Analyses the strengths, weakness,

    opportunities and threats of situations

    and develops long term approaches

    that have a positive impact on the

    business. Uses sound judgment to

    manage change. Champions new ideas

    and supports others to plan and

    implement change initiatives

    Developing, Managing & Working

    with Hybrid Teams

    Encourages and leverages diversity by

    utilizing individual strengths and actively

    builds hybrid teams with

    complementary skills. Proactively takes

    efforts to share experience/ relevant

    ideas/ information/views and provide

    guidance to other team members

    working remotely to achieve goals.

    Effectively communicates and cascades

    various business initiatives to hybrid

    teams to drive business results by

    leveraging technology. Anticipates and

    is prepared to effectively deal with

    problems and roadblocks faced while

    working with hybrid teams. Encourages

    work-life balance amongst team to

    maintain healthy workforce. Proactively

    recognizes team members for their

    triumphs and encourages their self

    development. Is able to adapt person

    -specific approach while dealing with

    various team members.

    Technology,

    Digital and Analytics

    Ability to analyze current technological

    trends, keeps track of key technological

    changes in industry and other markets

    Shows agility for adopting new

    technology post systematic evaluation

    of the the solution. Continuously stays

    in touch with key networks and

    contacts, with an objective of

    leveraging technology for achieving

    goals. Effectively balances changing

    technological priorities and deliverables

    under unfamiliar situations or tight

    deadlines. Independently engages in

    tasks requiring interpretation of

    complex and often vague sets of

    information. Identifies gaps in

    information and makes assumptions in

    order to continue analysis and/or take

    action. Promotes digital literacy and

    fluency in the team

    G:

    Behavioral (Refer Appendix for details)

    Level 1

    (rarely / not required)

    Level 2

    (required frequently)

    Level 3

    (essential for position)

    Interpersonal skills

    Communication skills

    Creative thinking skills

    Supervising/Leadership skills

    Teamwork Skills

    Influencing skills

    Relationship Building skills

    Decision making skills

    Incumbent Characteristics

    Essential

    Qualification

    Graduate

    Experience

    8-12 years

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