ICLM Health Investigations - Bangalore,Chennai,Hyderabad,Mumbai

Role: Manager / Senior Manager / Chief Manger /AVP-Health Investigations

Vertical : ICLM Health Investigations

Experience : 0 To 10+ years

Lead and manage large teams for Health Claim investigations(CAT)

Allocating claims investigation to internal and external resources

Fraud Detection

Identifies issues and potential solutions on all aspects of the claim processing & Investigation

Taking regular and timely follow-up of allocated claims with internal and external resources.

Carry out audit on the closure provided by internal and external resources.

Adherence to TAT and Quality Guidelines

Analysis of MIS reports / dashboards on time to time, inputs share to concern stakeholders. For

constructive change which help in betterment of growing business.

• Education qualification: Needed is MBBS/ BHMS / BAMS/ BDS / D Pharm / B Pharm / Physiotherapist

Key Skills

• Health Claim Investigations
• Fraud Detection & Analysis
• Claim Processing
• Risk Assessment
• Team Leadership
• Digital & Hybrid Investigation Techniques
• Evidence Collection & Documentation
• Compliance & Regulatory Adherence
• MS Office & Excel Proficiency Professional

Interested candidates can share their updated profile at shobha.samal@ext.icicilombard.com

or 7045338823