About The Role

Responsible for managing customer grievances, management escalations, regulatory complaints (IRDAI), and service-related issues. The role focuses on ensuring timely resolution of complaints, maintaining regulatory compliance, coordinating with internal/External stakeholders, and delivering a positive customer experience while adhering to defined service standards.

Handle customer grievances and complaints related to health claims.
Manage management escalations and ensure prompt resolution within defined timelines.
Respond to and resolve IRDAI, Ombudsman, and other regulatory complaints in compliance with regulatory guidelines.
Coordinate with claims, underwriting, operations, and customer service teams to obtain required information and resolve cases.
Draft customer and regulatory responses with accuracy and professionalism.
Track complaint aging, turnaround time (TAT), and closure status through CRM systems.
Conduct root cause analysis of recurring complaints and recommend corrective actions.
Ensure adherence to company policies, regulatory requirements, and service quality standards.
Prepare MIS reports, dashboards, and escalation summaries for management review.
Maintain complete documentation and audit-ready records of all grievance and escalation cases.
Support process improvement initiatives aimed at reducing complaints and enhancing customer satisfaction.
SSC
Higher Secondary (HSC)
B. Com Graduate