AM/Senior Executive - Fraud & Risk Control Unit
Job Description:
Primary Role Description: - • Responsible to monitor the quality of investigations carried out by the investigation agencies &
verification officers
• To quality check the investigation reports & evidences received from field and submit with
recommendation for claim processing
• Co-ordinate with field investigators and help/guide them on claim investigations
Key Roles & Responsibilities: • To comply with departmental SOP with respect to: fraud investigation, reporting and recovery
• Close liaison with the claims team, investigation agencies and other stakeholders in terms of fraud
investigations and outcomes
• Participate in relevant training activity and regularly upgrade knowledge in the area of fraud risk
management
Measurement and documentation
A medical graduate (BDS/BPT/ BAMS/ BHMS)
• Minimum 1+ years of experience in the health insurance claims/ fraud investigations or related areas
Key Requirements - Experience & Skills • Good working knowledge of MS Office (MS Word, MS Excel, MS PowerPoint).
• Good analytical skills
• Good organizational, planning and delivery skills
• Strong people management /interaction skills
• Fluent in Hindi and English both written and spoken
• Team handling skills/experience
• Multi-tasking and ability to work under pressure in a fast paced environment
• Adhering to Max Bupa principles and values
Key Skills :
Company Profile
(formerly known was Max --- Health Insurance Company Limited) is a joint venture between Fettle Tone LLP (an affiliate of True North Fund VI LLP), an Indian private equity firm, and the UK based healthcare services expert, --- Singapore Holdings Pte
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