Team Member - Financial Controls

Aditya Birla Health Insurance Company Limited; Maharashtra; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Aditya Birla Health Insurance Company Limited is seeking a TM - Financial Controls to strengthen financial processes, controls, and risk management across claims, revenue, and costs.

You will evaluate processes, identify leakages, and work with Finance & Accounts to implement improvements that protect profitability and ensure compliance in a dynamic health insurance market.

Responsibilities

• Map and analyze end-to-end business processes (Claims, Commission, Refunds etc.).
• Identify control gaps, inefficiencies, and potential monetary leakages.
• Evaluate risk exposure related to financial transactions.
• Detect areas where revenue is lost or costs are unnecessarily incurred.
• Quantify financial impact of identified leakages.
• Perform data analytics on transaction data to detect anomalies.
• Reconcile financial records with operational processes.
• Use tools like Excel, ERP reports, SQL, or analytics tools to identify irregular patterns

Job description

BusinessFinancial Services

Poornata Position Title of the jobTM - Financial Controls

Basic Details: Fill the required information about business, unit, location, position, reports to position and date of updation of JDBusinessFinancial ServicesUnitAditya Birla Health Insurance Company LtdLocationGcorp, MumbaiPoornata Position Number of the jobReports to: Poornata Position NumberPoornata Position Title of the jobTM - Financial ControlsReports to: Poornata Position TitleCFOFunctionFinance & AccountsReports to: FunctionFinance & AccountsDepartmentF&A - Accounts & TaxationReports to: DepartmentHead - ControlsDesignation of the EmployeeDesignation of the ManagerDate of writing/updation of JD

• Job Purpose: Write the purpose for which the job exists (in 2-3 lines)

To evaluate business processes and financial controls to identify monetary leakages, revenue loss, excess costs, and control gaps, and recommend improvements that enhance profitability, compliance, and operational efficiency.________________________________________

• Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job.

Business Workforce Number (Max 254 Characters) Unit Workforce Number (Max 254 Characters) Function Workforce Number (Max 254 Characters) Department Workforce Number (Max 254 Characters) Other Quantitative and Important Parameters for the job: Budgets/ Volumes/No. of Products/Geography/ Markets/ Customers or any other parameter

• Job Context & Major Challenges: Write the specific aspects of the job that provide a challenge (internal and external) to the jobholder in the context of the Business/Unit/Function/Department/Section

About The Health Insurance Industry –While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business. Also by creating an inexpensive and standardized solution to increase the reach into the pockets of channel partners across the country to harness on their captive business and explore new opportunities with them. Market Opportunities – With the advent of medical advancements, lifestyle changes, change in Indian socio-economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.

About The Aditya Birla Health Insurance –Aditya Birla Health Insurance Co. Limited (ABHICL), a part of Aditya Birla Capital Ltd. (ABCL), is a joint venture between Aditya Birla Group and MMI Holdings of South Africa. ABHICL was incorporated in 2015 wherein Aditya Birla Capital Limited (ABCL) and Momentum Metropolitan Strategic Investments (Pty) Limited (Formerly known as MMI Strategic Investments (Pty) Ltd.) were holding 51% and 49% equity shares respectively. ABHICL commenced its operations in October 2016 and is engaged in the business of health insurance. Company’s current product portfolio includes unique offerings including chronic care and incentivized wellness. ABHICL became an associate company of Aditya Birla Capital Limited (ABCL) on October 21, 2022 post the allotment of 9.99% of equity shares of the Company to Platinum Jasmine A 2018 Trust, acting through its trustee Platinum Owl C 2018 RSC Limited (‘Investor’), an affiliate of Abu Dhabi Investment Authority (‘ADIA’). Consequently, Aditya Birla Capital Limited (ABCL) and Momentum Metropolitan Strategic Investments (Pty) Limited (Formerly known as MMI Strategic Investments (Pty) Ltd.) holds 45.91% and 44.10% of shares respectively. As on FY24 end, ABHICL recorded a gross written premium (GWP) of Rs.5000 Crore and covered more than 2.5 Cr lives. ABHICL has nation‑wide distribution presence in over 5000+ cities through 250 branches and partner offices, 18 bancassurance partners and over 100000 Advisors. ABHICL has scaled and diversified digitally enabled distribution through 40%+ agency growth with 250 branch locations, bancassurance available through 16,000+ branches, and 39+ digital partners covering 6 Mn.+ lives through 50+ contextual byte-sized products. ABHI’s unique offering to market includes proposition includes

• A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthy
• A Chronic Care Management Program to cater to the unmet needs of a growing Indian population of those suffering from chronic lifestyle conditions like Diabetes, Asthma, High Cholesterol and Hypertension from Day 1
• ABHICL serves as an enabler and influencer of health and healthcare choices that customers make, in addition to being a payer of healthcare expenses. Thus, ABHICL would act like a much needed catalyst to grow the prevalent health insurance landscape in India through product innovations and a wider choice of consumer relevant products.
• ABHICL’s vision has always been digital. The company has been successful in adopting paper‑less approach right from identifying to on‑boarding to delivering seamless experience of its customers & employee
• Key Result Areas: Write the key results expected from the job and the supporting actions for each of these key result areas (For a majority of jobs typically there could be 4‑ 7 key result areas)

Key Result AreasSupporting Actions

Process Review & Risk Assessment

• Map and analyze end-to-end business processes (Claims, Commission, Refunds etc.).
• Identify control gaps, inefficiencies, and potential monetary leakages.
• Evaluate risk exposure related to financial transactions.

Monetary Leakage Identification

• Detect areas where revenue is lost or costs are unnecessarily incurred.
• Quantify financial impact of identified leakages.

Data Analysis & Financial Review

• Perform data analytics on transaction data to detect anomalies.
• Reconcile financial records with operational processes.
• Use tools like Excel, ERP reports, SQL, or analytics tools to identify irregular patterns

Internal Control Evaluation

• Review adequacy and effectiveness of internal financial controls (IFC).
• Test compliance with SOPs, policies, and regulatory requirements.
• Identify fraud risks and control weaknesses.

Audit Testing

• Conduct sample testing of transactions across processes.
• Validate approvals, documentation, and pricing controls.
• Check adherence to contracts, agreements, and company policies

Internal Controls

• Establish and maintain effective internal controls to safeguard assets, ensure accuracy in financial reporting, and prevent fraud.
• Conduct regular audits to assess the effectiveness of internal controls and recommend improvements.

Recommendations & Process Improvement

• Provide actionable recommendations to plug financial leakages.
• Suggest process redesign or automation where necessary.
• Support management in implementing stronger controls.
• Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)
• Relationships: Describe the nature and purpose of most important contacts or relationship (except superior/team members) with individuals, departments, organizations inside and outside of the organization, that job is required to interact with in order to deliver the job objectives

Relationship Type Frequency Nature Internal All Accounts Units All Other Functions Ongoing Quarterly Ensuring the veracity of numbers flowing to financials and reconciliation status of all balance sheet codes For Stat Audit Closure External Stat Auditors Internal Auditors Shareholders IRDAI Quarterly Quarterly Monthly Ongoing For Stat Audit For all pending Points For Financials For all Financials Related Submissions

Organizational Relationships: Provide the structure for a level above and below the position for which this job description is written. Use position titles in the structured and indicate all the reports of the position.

SIGN-OFF: Provide the name of the Manager and the jobholder. Signature needed for the hard copy of the JD. Hard copy to be maintained in the organizational record.

Job Holder Reports to – Manager Name Signature (needed for the hard copy)