Claim & Quality Auditor

As a detail-oriented and experienced Claim & Quality Auditor, your role will involve ensuring accuracy, compliance, and efficiency across the claims process. You will be responsible for the following key responsibilities: - Conduct regular audits of insurance claims (health, life, motor, or general) to ensure compliance with internal policies and regulatory guidelines. - Review claim documentation, approvals, and settlements for accuracy, completeness, and consistency. - Identify discrepancies, errors, or potential fraud and provide detailed audit findings to relevant stakeholders. - Develop and implement quality assurance metrics and audit checklists. - Collaborate with claims, underwriting, and operations teams to ensure continuous process improvement. - Provide training and feedback to claim processors and assessors on audit findings and best practices. - Prepare detailed audit reports and summaries for management review. - Track audit results, monitor corrective actions, and ensure timely closure of non-compliance issues. - Support compliance and risk management initiatives by maintaining updated knowledge of IRDAI and other regulatory requirements. Qualifications required for this role include: - Bachelor's degree in Insurance, Commerce, Finance, or a related field (Masters preferred). - 3 years of experience in claims auditing, quality assurance, or insurance operations. - Strong understanding of insurance claim processes, documentation, and regulatory requirements. - Excellent analytical, investigative, and problem-solving skills. - High attention to detail and accuracy. - Proficient in MS Excel, audit tools, and claims management systems. - Strong communication and report-writing skills. The company values your expertise in claim auditing and quality assurance to contribute to the overall operational efficiency and compliance. This full-time position requires your presence at the in-person work location.,