Roles and Responsibilities
- Maintaining track of all pending Mediclaim cases ensure on the closure of the same within TAT. Coordinate with broker & insurance companies for resolution on pending cases.
- Ensuring proper implementation of Mediclaim Policy.
- Preparing MIS reports on weekly basis with details of Claim reports & claim ratio.
- For all Cashless claims, directly deal with the Employees & TPA for smooth functioning of the claim settlement.
- Conducting monthly/ quarterly meetings with the TPA /brokers/ insurance company to ensure smooth running of the operations.
- Interact with insurance TPA for monthly addition & deletion of employees
- For all the Reimbursement claims collect & scrutinise the documents as per the SOP & submit to Insurance TPA on timely basis. .
- Coordinate with brokers, insurers and internal Finance / Accounting / Accounts Payable team to ensure timely payment of claim amount.
- Prepare presentation with detailed analysis during renewal & quarterly review meetings.
- Arrange the E-cards to the new as well as existing employees to facilitate them to avail the Cashless facilities at PAN India Level.
- Manage communication / employee awareness about mediclaim insurance with all employees
- Enable & educate employees to use the TPA app for employee self service & train employees including new hires to register on the app.
- Be the one point of contact for all Mediclaim & employee wellness needs.
- Facilitate non-monetary employee benefits awareness sessions and wellness related training sessions for PAN India employees
Key Result Areas
- Ensure 90% of the claims are settled before the policy renewal.
- Timely updation of addition and deletion to avoid rejection of claims.
- Restrict the claim rejection to 2% or less of overall claims.
- Ensuring 100% accuracy & update of MIS/ Intranet information by set deadlines.
- Employee Relations & engagement initiative.
- Ensure renewals of the insurance policies before due dates
Salary: Not Disclosed by Recruiter
Employment Type:Full Time, Permanent
UG:Any Graduate in Any Specialization
Transasia Bio-Medicals Ltd.