Job Description

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 / Physiotherapis t 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