Senior Manager - Claims

Hotelecia; Mumbai; On-site; INR 300,000 - 500,000; Full time

Job summary

Hotelecia in Mumbai is seeking an entry-level Claims Analyst to support end-to-end claim settlement and regulatory compliance. The role involves handling individual and group death claims with emphasis on accuracy, timelines, and customer sensitivity.

The candidate should have graduate or postgraduate education with strong communication skills and will work with cross-functional teams, including Legal, Fraud Control, and Reinsurers, to close claims within SLA.

Qualifications

• Graduate or postgraduate with strong communication skills.
• End-to-end claim handling knowledge is preferred.

Responsibilities

• Prudent claim assessment and management of end to end claim settlement/repudiations including Individual and Group claims
• Compliance over regulatory guidelines especially extensive knowledge on Group claims
• Coordinate with Legal/Fraud Control Unit/Reinsurers/sales/customers for closure of claims within regulatory framework and timelines
• Trend analysis of claims data by channel and amount to highlight mortality experience and implement controls
• Direct and oversee the maintenance of complete and accurate claim management records
• Managing the claim teams on day-to-day transactions with guidance on claims philosophy, regulatory and audit procedures
• Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality
• Ensure customer-centric approach while delivering sensitive area of death claims
• Co-ordinating with reinsurers for high value claims
• End-to-end claim handling and settlement
• Regulatory compliance and audit readiness for all claim activities

Skills

Communication skills

Education

Graduate or Postgraduate

Job description

Key Responsibilities:

• Prudent claim Assessment and management of end to end claim settlement /repudiations including Individual and Group claims
• Compliance over regulatory guidelines especially extensive knowledge on Group claims
• Coordinate with Legal/Fraud Control Unit/Reinsurers /sales/customers for closure of claims within regulatory framework and timelines
• Trend Analysis of Claims data, channel wise, amount wise etc. required for highlighting mortality experience and implementing controls at all required ends
• Direct and oversee the maintenance of complete and accurate claim management records.
• Managing the claim teams on day to day claims transactions, guidance on claims philosophy, regulatory and audit procedures
• Ensuring daily claim deliverables are met and claims decision within prescribed SLA with quality
• Ensure customer centric approach while delivering sensitive area of death claims
• Co-ordinating with reinsurers for high value claims

Key Responsibilities:

• Prudent claim Assessment and management of end to end claim settlement /repudiations including Individual and Group claims
• Compliance over regulatory guidelines especially extensive knowledge on Group claims
• Coordinate with Legal/Fraud Control Unit/Reinsurers /sales/customers for closure of claims within regulatory framework and timelines
• Trend Analysis of Claims data, channel wise, amount wise etc. required for highlighting mortality experience and implementing controls at all required ends
• Direct and oversee the maintenance of complete and accurate claim management records.
• Managing the claim teams on day to day claims transactions, guidance on claims philosophy, regulatory and audit procedures
• Ensuring daily claim deliverables are met and claims decision within prescribed SLA with quality
• Ensure customer centric approach while delivering sensitive area of death claims
• Co-ordinating with reinsurers for high value claims

Short Info

• Qualifications: Graduate/Post graduate with required communication skills,
• Experience: 0 Years - 0 MonthsTo0 Years - 0 Months