Field Verification Officer – Health Claims Investigation

As a Field Verification Officer specializing in Health Claims Investigation, you will play a crucial role in ensuring the accuracy and legitimacy of health claims. This position is in the health insurance sector, working within a mid-sized company that operates in a dynamic and challenging environment. You will have the opportunity to make a significant impact by safeguarding resources against fraudulent claims while upholding the integrity of the claims process. This full-time position is based in Raipur, Chhattisgarh, India, and offers a unique blend of fieldwork and investigative analysis. Key Responsibilities Conduct field investigations to verify health claims and confirm the authenticity of submitted documents. Engage with healthcare providers, claimants, and relevant parties to collect detailed information and facilitate interviews. Document findings meticulously and prepare comprehensive reports to support claims assessments. Maintain confidentiality and adhere to regulatory requirements during investigations. Utilize observation and analytical skills to identify discrepancies and potential fraud indicators. Coordinate with internal teams such as claims processing, legal, and compliance for a holistic review of cases. Manage time efficiently to handle multiple investigations while meeting deadlines and quality standards. Required and preferred qualifications Bachelor's Degree in a relevant field. Strong observation and communication skills; proficiency in both verbal and written communication. Ability to perform detailed verification and documentation processes. Demonstrated problem-solving skills, with an aptitude for analytical thinking. Prior experience in claims processing, insurance investigation, or a related field is preferred. Familiarity with regulatory standards and guidelines in health claims is a plus. The ideal candidate will thrive in a collaborative team structure, reporting to the Claims Investigation Manager. You will work closely with claims analysts and other officers to ensure all findings are appropriately integrated into the claims process. Cross-functional collaboration with legal and compliance departments will also be required to address complex cases. We offer a supportive company culture that encourages growth and development. Employees can take advantage of modern workplace perks, including flexible working hours and continuous professional development opportunities. Join our team to not only advance your career but also contribute to a mission of integrity and ethical administration in health claims.