Executive HAT Care Unit-HAT Coordinators

Claims Administration and Management ﾧ Coordinate with branches in resolving the claims within the set SLAs / TATs; resolve any issue / concern ﾧ Review the claim settlement status daily; guide team in addressing claims which exceed TAT; seek clarifications and resolve issues to ensure that the claims are processed at the earliest ﾧ Conduct reviews (OFR / CFR) to identify problems within claims settlement and propose solutions; discuss the same with the superior and seek feedback / assistance in the same TPA Management ﾷ ﾧ Connect with the TPA vendors and invite quotes; assess information like loss ratio/ service expectations, etc.; ﾧ Negotiate with the TPAs on different aspects; assess loss ratio and drive action to arrest the same by seeking assistance from underwriting team on premium / risk assessment, etc. ﾧ Share policy details, benefits and nuances; train them on the specifics of the policy and how to administer the payment / claim processing Report Generation (MIS) ﾷ ﾧ Generate MIS on set frequency and apprise relevant stakeholder of the claim status within the team ﾧ Provide clarifications / reasons in case of delayed claim settlement Team Training ﾧ Lead training efforts for upskilling of team to better deliver in terms of claims administration, settlement, issue resolution, etc. ﾧ Provide directions in planning and coordination of training efforts for team ﾧ Motivate and retain key talent in the team Process Improvement ﾧ Collaborate with technology teams internally to drive implementation of tech-based platforms for claims processing, etc. ﾧ Support different internal teams to come up with innovations / process improvement and drive its implementation for effective claims management Team Development and Engagement ﾧ Establish location wise performance expectations and evaluation metrics, and regularly review location wise performance ﾧ Share information regarding business and key developments with the team proactively; guide them in utilizing their skills in the best possible manner ﾧ Understand team grievances and guide for their effective resolution ﾧ Identify and create development opportunities for team members to enhance functional knowledge Show more Show less