- Role: Senior Executive – Claims Investigation (100% Backend Operations, In-Person).
- TPA Experience: Mandatory 2–5 years of core experience in TPA backend operations, health insurance claims processing, or fraud investigation.
- Excel Requirement: Advanced Excel proficiency is strictly mandatory (must be highly skilled in VLOOKUP, Pivot Tables, and logical formulas for data analysis).
- Claims Scrutiny: Thoroughly investigate, verify, and validate high-value or suspicious TPA insurance claims entirely from the backend.
- Data & Reporting: Manage large claims datasets, track fraud trends, and generate daily/weekly investigation reports using Excel.
- Risk Mitigation: Identify red flags, patterns, and documentation anomalies to prevent fraudulent claim payouts.
- Coordination: Collaborate seamlessly with internal medical, legal, and underwriting backend teams to close investigation files.
- Documentation: Maintain precise compliance records, audit trails, and detailed case summaries for all investigated claims.
- Qualifications: Graduate degree in any stream with sharp analytical skills and strong written communication for backend reporting.
Pay: ₹20,000.00 - ₹25,000.00 per month
Benefits:
- Paid sick time
- Paid time off
- Provident Fund
Education:
Experience:
Work Location: In person
