We want Crisp, Who have presence of mind and sharp people for the claim verification and investigation purpose.
A Claims Investigator is responsible for investigating insurance claims to verify their authenticity, identify fraudulent activities, and ensure claims are processed according to company policies.
- Required Skills:Excellent verbal and written communication skills.
- Robust analytical and observation skills.
- Ability to conduct interviews professionally.
- Report writing and documentation skills.
- Knowledge of insurance claims and healthcare terminology is an advantage.
- Proficiency in MS Office (Word, Excel, Outlook).
- Ability to travel for field investigations when required.
- High level of integrity, confidentiality, and professionalism.
- Performance Metrics:Number of investigations completed within TAT.
- Accuracy and quality of investigation reports.
- Success in identifying fraudulent or non-genuine claims.
- Compliance with SOPs and documentation standards.
- Customer and stakeholder professionalism during investigations.