We have opening for the post of Medical Officer/ Deputy Manager- claims and investigation at Ahmedabad Location.

Total Experience: More than 1 Years (Fresher's Can Apply)

Designation: Investigation Officer

Job Location: Ahmedabad

Salary: No bar for the right candidate

We are looking for a talented Deputy Manager- Claims and Investigation to be responsible for identifying and handling suspicious or problematic health insurance claims while providing consultation and opinion through professional reports. The ideal candidate should have demonstrable analytical skills along with a passion for research and investigative evidence analysis.

Job Responsibilities:

- Conduct objective, fair, thorough, unbiased and timely investigations into allegations of fraud, waste or abuse committed by claimants/providers / any other stakeholders in health insurance claims

- Review and research evidence/documents to analyze the overall fact pattern of the claim and synthesize data into a professional report with recommendations

- Prepare and coordinate field assignments to obtain relevant evidence and information

- Coordinate with the Corporate office to provide recovery strategies and use legal resources for assistance

- Manage and prioritize a large and varied caseload effectively and efficiently to achieve positive results

- Write a Narrative report based on investigation conducted with evidence to support.

Educational Requirements:

- Degree / Diploma Holder - Science Background with Biology Required

- Candidate from Nursing/Diploma Pharmacy/Biotech/Laboratory tech/Medical Engineering/DMLT can also apply.

- Basic Computer knowledge with experience in MS Office (Word / Excel).

Skills :

- Strong interpersonal & communication skills

- Good verbal & written communication skills - Should know English and local language

- Strong analytical skills

- Proficient with insurance procedures regulations & investigation methods.

- Good interviewing & interrogation skills along with the capability of drafting reports.

- Honest & ethical with high levels of integrity & confidentiality.

Interested candidate can share resume in Word Format

Dipali Kurmi
+91 9601190905/
Talish Solutions

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