01Overview
Field Claim Investigator
Location: Mumbai | Ahmedabad | Surat | Baroda/ Vadodara
Experience: 1-5 years
Industry: Health Insurance
Role & responsibilities
- Visit hospitals, nursing homes, and policyholder residences to verify health insurance claims
- Check medical bills, discharge summaries, prescriptions, and other documents for accuracy
- Meet patients, doctors, and hospital staff to confirm treatment details
- Identify signs of fraud, fake bills, or mismatched information
- Prepare and submit explicit, on-time investigation reports
- Coordinate with the claims and TPA team to close cases within TAT
- Maintain proper records of all site visits and findings
- Travel within the assigned city/region as per daily claim allocation
Preferred candidate profile
- Prior experience in claim investigation, TPA, or health insurance preferred
- Comfortable with daily field travel and visiting hospitals/homes
- Good observation skills and attention to detail
- Basic computer knowledge for report writing and data entry
- Own two-wheeler and valid driving license preferred
- Good communication skills in local language and Hindi/English
Connect: 9893089743 | HR Ishika .
