SPOC

WE ARE HIRING SPOC (Digital Portfolio) Phoenix Assurance Pvt. Ltd. Are you a healthcare professional with experience in Health Insurance Claims, Medical Audit, or Claim Investigation Join one of India's leading insurance investigation companies and build your career in the growing field of Digital Health Claim Investigation. --- Position SPOC Digital Portfolio Work From Home / Office Location: Work From Home / Office (PAN India) Salary: Up to 30,000/- per Month (Based on Experience & Interview Performance) Working Hours: 10:00 AM 6:30 PM Working Days: Monday to Saturday (Sunday Off) Leave Benefits: 1.5 Paid Leaves per Month --- Your Role As a Digital Portfolio SPOC, you will be responsible for handling digital health insurance claim investigations, verifying claim authenticity, coordinating with field teams, and interacting directly with insured members through calls and video verification. --- Key Responsibilities Conduct medical and claim verification for Health & Personal Accident (PA) insurance claims. Connect with insured members through phone calls and video calls to verify: Identity of the insured Hospitalisation details Diagnosis and reason for admission Previous medical history Treatment received Policy-related information Any discrepancies or suspicious observations Ask relevant medical and investigation-related questions on behalf of the company while maintaining professionalism and empathy. Validate claim information through digital verification and accurately document all findings. Coordinate with Field Officers for further physical investigation whenever required. Review medical documents, investigation reports, discharge summaries, prescriptions, bills, and supporting records. Ensure every assigned claim is completed within the prescribed Turn Around Time (TAT). Identify medical discrepancies, policy violations, fraud indicators, and suspicious claim patterns. Coordinate with hospitals, insurance companies, TPAs, and internal teams for clarification and timely claim closure. Maintain daily MIS, case trackers, productivity reports, and investigation updates. Ensure complete compliance with Company SOPs, client requirements, and regulatory guidelines. Maintain strict confidentiality of all client, company, and insured information. --- Daily Performance Target* Handle & Close Minimum 15 Claims Per Day --- Eligibility Criteria Qualification (Mandatory) MBBS BHMS BAMS BDS BPT Experience Minimum 2 Years of experience in: Health Insurance Claims Medical Audit Claims Investigation Hospital Operations Clinical Documentation Healthcare Operations (Candidates with Health Insurance Investigation experience will be given preference.)* --- Required Skills Excellent communication skills (Hindi & English) Strong clinical knowledge and medical understanding Good interviewing and questioning skills Ability to conduct professional telephonic and video verifications Strong analytical and decision-making abilities Good knowledge of MS Excel, Google Sheets & MIS Reporting Ability to work independently in a remote environment Laptop/Desktop with stable high-speed internet connection (Mandatory) --- Why Join Phoenix Assurance 100% Work From Home Opportunity Work with Leading Insurance Companies & TPAs Exposure to High-Value Health Insurance Investigations Career Growth in Medical Audit & Digital Claims Investigation Performance-Based Growth Opportunities Professional & Supportive Work Culture --- Immediate Joiners Preferred Apply Now (mailto:hr@phoenixassurance.in) +91 63588 67436 --- Phoenix Assurance Pvt. Ltd. Building Trust Through Professional Insurance Investigation & Claim Verification .