Role: Claims Manager
Industry Type: Insurance
Department: BFSI, Investments & Trading
Employment Type: Full Time, Permanent
Role Category: BFSI, Investments & Trading - Other
UG: Any Graduate
PG: Any Postgraduate
Roles and Responsibilities:
- ò Prudent understanding of all Claims.
ò Compliance over regulatory guidelines especially knowledge on Retail and Group Claims
ò Manage all claim-related customer queries, complaints, and service requests across channels and touchpoints including IGMS complaints
ò Co-ordinate the Customer complaints team to ensure timely closure of all complaints
ò Drive root cause analysis (RCA) for complaints and implement corrective actions.
ò Manage the Quality Control for the claims team by conducting hindsighting reviews and data audits
ò Establish and monitor quality benchmarks, KPIs, and SOP adherence.
ò Act as a key point of contact for branch teams, distribution channels, and internal touchpoints
ò Conduct regular stakeholder connects to address operational challenges and improve service delivery
ò Deliver training programs for claims teams on processes, complaint management and Quality standards.
ò Process Governance by review of Claim SOP, Communications and Forms etc to ensure documents are updated, standardized, and compliant with regulatory requirements
ò Identify opportunities to improve customer journey and experience
ò Identify opportunities for automation and digital transformation in claims processes
ò Ensuring deliverables are met with prescribed SLA with quality.
ò Ensure customer centric approach while delivering sensitive area of death claims
Job Requirements:
- Life Insurance domain knowledge
- Exceptional customer handling skills
- Analytical thinking with focus on RCA and process improvement
- Stakeholder management and cross-functional collaboration
- Leadership and team development capabilities
- Excellent presentation skills for team communication, training delivery and RCA update
- Strong communication and documentation skills
- Decision making and team handling skills