Team & People Management
o Lead, coach, and manage the Claims Support team to ensure consistent performance and service quality.
o Allocate claims effectively across the team and ensure optimal workload distribution.
o Monitor individual and team KPIs such as TAT, accuracy, closure rate, and customer satisfaction.
o Conduct regular performance reviews, feedback sessions, and training interventions.
o Act as the first escalation point for team members on complex or sensitive claims.
Claims Operations
o Own end-to-end claim lifecycle governance across the team, from intimation, documentation, processing, approval/rejection, and closure.
o Ensure all claims are registered accurately with insurance companies and TPAs as per defined SLAs.
o Review documentation quality and ensure compliance with insurer-specific requirements.
o Proactively track aging claims and drive follow-ups to prevent delays.
o Handle high-value, critical, or escalated claims directly when required.
o Lead, coach, and manage the Claims Support team to ensure consistent performance and service quality.
Stakeholder & Escalation Management
o Serve as the primary escalation interface with TPAs and insurance companies for unresolved or delayed claims.
o Maintain strong working relationships with insurer and TPA teams to improve turnaround and issue resolution.
o Coordinate with internal sales, operations, and relationship teams to ensure alignment and timely communication.
o Ensure timely and accurate communication to travel agents/customers in case of exceptions or delays.
MIS, Reporting & Compliance
o Review and publish daily/weekly/monthly MIS on claim volumes, TAT, pendency, rejection trends, and escalations.
o Ensure accurate documentation and record maintenance to support audits and compliance requirements.
o Analyze data to identify recurring issues, bottlenecks, and insurer/TPA-related challenges.
Process Improvement
o Drive continuous process improvements to enhance efficiency, reduce claim TATs, and minimize errors.
o Implement standard operating procedures (SOPs), checklists, and quality benchmarks for the team.
o Collaborate with leadership to implement automation or system enhancements where applicable.
o Ensure adherence to regulatory, insurer, and internal compliance standards.
