Job Status : Closed
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We are looking for an experienced Assistant Manager in the field of Medical Claims within the insurance industry. The ideal candidate will have a strong background in managing and overseeing medical claims processes, ensuring accuracy, efficiency, and compliance with industry standards. This role requires a strategic thinker with excellent leadership skills and a passion for delivering high-quality service.
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1. Bachelor’s degree in a related field; additional certifications in insurance management or claims processing are a plus.
2. Proven experience (3 years) in a similar role within the insurance industry, with a focus on medical claims.
3. Strong knowledge of medical terminology, coding, and billing processes.
4. Excellent leadership and interpersonal skills with the ability to motivate and mentor team members.
5. In-depth understanding of insurance regulations and compliance standards.
6. Exceptional analytical and problem-solving abilities.
7. Proficient in relevant software and tools.
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1. Supervise Production & Underwriting teams and day-to-day Operations
2. Oversee Compliance & Regulatory requirements and enforcement
3. Develop and update Medical Underwriting & Operations Process Manuals
4. Handle Underwriting for New & Renewal Business
5. Prepare Production Reports and conduct Pricing Review
6. Contribute to the Development of New Products
7. Engage in Business Development activities
8. Generate Portfolio Analysis Reports for Medical and conduct Reserving Review
9. Provide Client Servicing and update scheme performance
10. Manage System Requirements/Developments
11. Check and process documents including quotations, policies, accounting docs, endorsements, memo’s, etc.
12. Regulate underwriting and operations processes as directed by the Dept. Manager
13. Ensure completeness of applications received from potential policyholders
14. Review acceptable risk factors in accordance with the Company’s underwriting policy and guidelines
15. Review and approve insurance policies and endorsements
16. Determine insurance premiums in line with the company’s established methods
17. Assess the company’s capacity to assume the appropriate risk factor
18. Provide guidance on reinsurance treaty limits, terms, and conditions, and communicate changes in treaty information
19. Conduct routine training for team members to keep them updated on prevailing regulations and system/process changes
20. Develop an underwriting policy outlining predetermined criteria for assuming business risk
21. Prepare periodic operational risk reports for management analysis
22. Generate periodic portfolio analysis reports for management review, including reviewing reinsurance structure
23. Perform other activities as and when requested
24. Provide support to the team for the smooth completion of tasks as needed
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