Investigation Executive-Claims

3 days ago


Chandigarh, Chandigarh, India Vidal Health Insurance TPA Private Limited Full time ₹ 20,000 - ₹ 24,000 per year

Vidal Health Insurance TPA is hiring for Investigation Executive – Claims (TPA)

Location: Chandigarh

Key Responsibilities:

  • Conduct field and desk investigations on flagged claims.
  • Verify documentation, treatment history, and hospital records.
  • Perform surveillance and gather evidence where required.
  • Liaise with hospitals, insured members, and internal teams to gather facts.
  • Collaborate with insurance companies and legal teams for case resolution.
  • Prepare detailed investigation reports with findings and recommendations.
  • Maintain accurate records of evidence, timelines, and communication trails.
  • Identify patterns of fraud or irregularities.
  • Ensure investigations comply with IRDAI guidelines and internal SOPs.
  • Provide feedback to improve claim screening and fraud detection protocols.
  • Support training initiatives for claims teams on red flags and triggers.
  • Qualifications & Skills:
  • Graduate in any discipline
  • 1–3 years of experience in health insurance claims or investigation from TPA Industry
  • Strong analytical and observational skills
  • Excellent communication and report writing abilities
  • Willingness to travel for field investigations
  • Proficiency in MS Office and claims management systems

Interested Candidate can connect

Job Type: Full-time

Pay: ₹20, ₹24,000.00 per month

Work Location: In person

Speak with the employer



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