Risk | Impact | Transformation | Intelligence

 Delivered peer benchmarking productivity report for 200+ insurers featuring line of business, blend of business, geography and organizational structure, including ESG metrics. Consolidated data-points’ from S&P Cap IQ Pro, Morningstar, Barrons, Dun & Bradstreet, Datanyze, Crunchbase, CB Insights, Pitchbook and Bloomberg to: Review and update merger and acquisition information, business model pivot for 2500+ global insurtech database. Re-model datasheet from Statutory, GAAP, IFRS - balance sheets, income statements of 60+ global P&C and life insurers.

Compliance and Audit Created and instituted internal & external stakeholders’ Standard Operating Procedures, hosted on OpenText. Faced 5 external audits, 3 internal risk-checks, mitigated 10 CRO risk observations and reduced 12 audit observations to 3. Regulatory filings and Management Information System Consolidated multiple excels from 8 TPAs through Python with support of tech team for change Reserves. Recommended robust BCP and API integration with TPA software systems.  Contributed to Policy wordings, Claims manual and claim form for Accident & Health and Travel policies.IT Analysis and System Development Drafted 4 User Requirement (UR) documents, Analyzed Solution Design Documents (SDD), Created 100+ Scenarios for SAP Fiori. Identified 35+ defects, tracked in JIRA for Renewal, Portability, Restoration, Catastrophe, Critical Illness claims. Flagged 10+ Service Requests (SR) using SAP Solution manager and monitored User Acceptability Testing (UAT). Key Result Areas Designed parametric-similar products’ claims process for 2 National Accounts placement and renewals. Developed claims flow in Pre-sales proposals for Middle markets along with Agency and Brokers, hosted webinars. Achieved ‘0’ litigation for 5 quarters, introduced ‘0’Cash for 19+ procedures for 100+ Providers, 1000+ Claims.

• Investigated 500+ indemnity claims in Reimbursement, Cashless hospitalization with a good hit rate.• Monitored adjudication protocols for Govt-sponsored Health Insurance coverage scheme.

• Supervised team and contributed to Training Modules for 8 doctors with Adjudication of over 8,000 health claims.• Attained reduction of average claim size for a client by 15% over 3 quarters.• Represented TPA at Ombudsman for litigated files and during Audit by Insurance firms.