Job Description

:


Desktop Investigation

• 
  Trigger identification through data at intimation/Referral stage
  Social media searches
  Cold calling using digital platforms
  Identify key business people, link analysis

Claim Investigation

• 
  Allocation of assigned claims to respective vendors with case relevant triggers
  Follow up for IR and TAT management
  Level 1 QC clearance & validate the submissions against shared triggers
  Success in claim investigation based upon strong medical & legal evidences
  Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing & creating evidence which stands in court of law
  Report submission and coordination with claims team.

Evidence Matrix Assurance

• 
  Ascertain evidence quality as per matrix
  Validate each & every evidence with the case triggers
  DMS of hardcopy maintenance

Escalation Management

• 
  Document Complaince through Field Investigation of HVC
  Further Requirement Complaince
  OFR and CFR with Stake holders

Data Management

• 
  MIS preparation and report reconciliation
  Payment reconciliation with Vendors
  Project tracking

Vendor Management

• 
  Vendor Empanelment & Training & Development
  Ensure the ethics and compliance during managing the external investigators and self- investigation of cases

Department :

South


Open Positions :

1


Skills Required :

Assessment of case triggers & provide to external vendors for filed investigation \xe2\x80\xa2 Validation of submitted evidences basis upon medical ethics , retrieved from the filed investigation


Location :

Bangalore


Education/Qualification :

Graduate/ Post Graduate


Desirable Skills :

1.Good communication skills. 2.Flexible & adaptable to change. 3.Well versed with MS Office. 4.Should have good analytical and problem-solving skills. 5.Should be aware of the Local language.


Years Of Exp :

2 to 6 Years


Posted On :

13-Nov-2023


Designation :

FFRM & Early Settlement Investigations