Required Assistant Manager-Claims Investigation(Kothrud,Pune)

Urgent requirement of Assistant Manager-Claims Investigation.

Job Description:

1. Trigger identification through data, Data Analysis, Revision and correction.
2. Follow up for Branches for TAT management.
3. Report submission and coordination with claims team.
4. Document Compliance through Field Investigation.
5. Investigating insurance claims for errors or fraudulent activity by reviewing medical records, interviewing staff/ Patients.
6. Reviewing claim documents to ensure they are complete and accurate before sending them to the next step in the claims process
7. Conducting internal audits to identify potential fraud within an organizations claims processing system
8. Reviewing medical bills and documents related to claims to ensure that they are accurate and supported by sufficient evidence
9. Conducting field investigations to collect Documents and evidences on supportive findings.
10. Investigating suspicious claims to determine whether they are fraudulent on supportive evidence.

Required Candidate profile:

• BAMS / BHMS / BDS graduate.
• Male candidate prefer.
• TPA Experience mandatory.
• Good Medical & basic computer knowledge
• Should have completed internship (Permanent Registration number is mandatory)
• Ready for field work.
• Work from office.

Venue details:

MDIndia Health Insurance TPA Pvt. Ltd.,

Karnavat Tower, 1St Floor, Paud Phata,

Behind Dashbooja Ganapati Temple,

Above Dena Bank, Kothrud, Pune - 411038, Maharashtra.

Contact Details:

Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com