LIFE INSURANCE UNDERWRITER (CONSULTANT) – OPERATIONS UNDERWRITING
Tata Aia Life Insurance
Total years of experience :6 years, 8 Months
•Underwriting both term & non-term insurance policies
• Underwriting both salaried, non-salaried, NRI clients
• Underwriting cases allotted as per assigned underwriting authority matrix & guidelines
• Scrutinize documents for completeness and check supporting documents to access the risks involved.
• Demonstrate proficiency in product lines and multiple stakeholders applicable to processing units
• Collaborate with risk management department in developing metrics for branch risk management
• Comply with internal company policy terms and conditions and quickly adopt to any proposed changes thereof
• Providing mentorship and training to new joinee’s for on-boarding purpose
• Accurate processing and completion of medical claims
• Process claims that route out of automatic adjudication, within TAT period
• Demonstrate proficiency in product lines and multiple stakeholders applicable to processing units
• Quality assurance pertaining to field investigator/agency reports and finalizing the same
• Comply with internal company policy terms and conditions and quickly adopt to any proposed changes thereof
• Providing mentorship and training to new joinee’s for on boarding purpose
•Handling claims for both Government & private hospitals
• Specialization with regards to PMJAY & NON-PMJAY cases
• Monitoring the overall operations of Claims and Preauthorization
• Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT
• Ensure adherence to processes and controls
• Creating the process for claim processing (Cashless and Reimbursement)
• Co-ordination between Network Hospitals/Preauthorization/Claims
• Ensuring a high-quality patient care at customized/optimized cost
• Creating the process for claim processing (Cashless and Reimbursement)
•Thoroughly inspected 6-8 patient per day and rule out problems and implement effective solutions.
• Educated patients on proper oral care routines.
• Administered anesthesia proficiently, surgical extraction of impacted tooth.
• Performed root canals, restored, and instructed patients on pain management to repair dental structures with minimal discomfort to patients.
• Created dental office policies and procedures, and oversaw rule enforcement to meet office guidelines as well as health and safety laws.
• Proficiently performed all phases of dental procedures
• Advised for the pathology test and evaluated test report to diagnose the condition.
•Demonstrated working knowledge of medical terminology and clinical best practice to provide best medical support.
• Oversaw day-to-day practice functions, including delivery of patient care, medical and administrative - staff.
• Analysed patients test results closely to ensure correct diagnosis and treatment planning
•Monitored the daily operations of healthcare institutions, quickly identifying defects and managing change.
• Planned and implemented strategic changes to improve servicedelivery, enhancing changes based on inefficient processes and procedures.
• Developed filing systems to improve patient records management and compliance confidentiality guidelines.
• Trained and educated over 100 Dental students.