We are hiring Managerial role in Vidal Health Insurance TPA for Assistant Manager for Investigation dept

Only TPA or Health Insurance industry will be preferred.

Qualification-BHMS/BDS/BAMS/BUMS only Doctors will be preferred

Immediate Joiner also required.

Job Title: Assistnat Manager

Job Location: Gurgaon, Udhyog Vihar Phase 5

Role Overview

We are looking for an experienced professional to lead the Investigation function within a Health Insurance TPA environment. The role involves handling suspicious and high-value claims, identifying fraud patterns, and ensuring effective risk control.

Key Responsibilities

- Lead investigation of suspicious and high-value health insurance claims
- Identify fraud patterns (inflated billing, unnecessary hospitalization, document manipulation, etc.)
- Conduct hospital audits and field investigations
- Review medical records, bills, and claim documents for discrepancies
- Coordinate with hospitals, insurers, and internal teams
- Prepare investigation reports with findings and recommendations




- Ensure compliance with IRDAI guidelines and internal processes
- Track MIS, dashboards, and fraud trends
- Manage and guide investigation team members

Key Requirements

- Strong knowledge of health insurance claims (cashless & reimbursement)
- Experience in fraud detection and hospital/provider investigations
- Understanding of medical billing and documentation
- Positive analytical and report-writing skills
- Strong stakeholder management skills

Qualifications

- BHMS/BDS/BAMS/BUMS
- 4-6 years of experience in TPA / Health Insurance investigations

Why Join Us

- Opportunity to work in a critical risk control function
- Exposure to complex and high-impact cases
- Leadership role with team management responsibility

Interested candidate can connect on (phone hidden) or [email protected] Job Types: Full-time, Permanent

Pay: ₹45,000.00 - ₹50,000.00 per month

Benefits

- Health insurance
- Provident Fund

Work Location: In person

📌 Assistant Manager Investigation (Gurugram)
🏢 Vidal Health Insurance TPA Private
📍 Gurugram