Senior Manager / Chief Manager – SIU

Position: Senior Manager / Chief Manager – SIU

Location: Goregaon, Mumbai

Key Responsibilities

• Handle health claims investigations for suspicious / high-risk claims

• Conduct investigations personally or through empaneled field investigators

• Prepare investigation plans / case strategy

• Guide and monitor field officers / investigators

• Review medical records, hospitalization details, and treatment patterns

• Submit comprehensive investigation reports to claims team

• Support fraud deterrence activities such as:

  • Police complaints / FIRs

  • Hospital escalations

  • Blacklisting / adverse action recommendations

• Work closely with claims, medical, legal, and fraud control teams

• Strengthen anti-fraud controls across the health claims portfolio

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MANDATORY QUALIFICATION FILTER

Must Have Medical Degree

Client is specifically open to:

• MBBS

• BDS

• BHMS

• BAMS

• B.PTh / BPT