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Health Investigations Manager

Health Investigations Manager

ICICI Lombard

2 - 7 years

2 - 6 Lacs

Chennai Bengaluru Mumbai (All Areas)

Posted:3 months ago| Platform:

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Skills Required

Fraud Investigation Claim Investigation Medicine Knowledge Group claim Retail claim

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role: Investigation Manager and have to manage daily work load of 15 to 20 claims end to end Triaging of claims from larger pool. Conduct ground inquiry with respect to brief of the case to understand the authenticity of the submitted cashless/ reimbursement/ death/ disability claim. Claim Assistance officer need to meet related person/ entity like insured/ claimant, vicinity check, hospital visit to collect claim relevant documents, meet treating doctor/ pathologist/ radiologist/ pharmacist and collect statement and relevant information which can help in adjudication of the claim. Officer needs to work on system to update the field work done on the case on regular basis and close the cases in system within stipulated TAT. Allocating claims to internal and external resources 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. Have as strong hold on allocated claims and get the desired result by involving in to real time discussion with external resources. Maintain TAT and success ration as per the standard regional. Have to be ready to go down on ground as and when required to investigate health claims. Have to be open to travel across the state in hospitals.

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ICICI Lombard

www.icicilombard.com

Insurance

Mumbai

4,000+ Employees

359 Jobs

Key People

N.S. Kannan

Managing Director & CEO
Bhargav Dasgupta

Executive Director
Siddharth Ghosh

CFO
Anuj Tyagi

Chief Technology Officer

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Health Investigations Manager

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