Deputy Manager - Risk and Loss Mitigation

HDFC ERGO General Insurance; Bengaluru; Sur place; INR 1 200 000 - 1 800 000; Plein temps

Résumé du poste

HDFC ERGO General Insurance is seeking a Deputy Manager - Risk and Loss Mitigation to lead field investigations of complex claims. You will verify evidence, coordinate with hospitals, TPAs, and insurers, and prepare comprehensive reports to support action.

The role demands analytical insight to identify trends and drive cost-saving improvements. Responsibilities include MIS reporting, maintaining ethical standards in investigations, and escalating grievances as needed.

Qualifications

• Medical graduates with relevant background in health insurance.
• Experience in claims investigation or processing is preferred.
• Proficient in Excel and basic data analysis.

Responsabilités

• Physical field investigation of claims assigned through system.
• Conduct field visits to hospitals, pharmacies, diagnostic centers; collect evidence and report.
• Prepare reports from findings, gather facts, and create court-ready evidence.
• Submit reports in the in-house CIMA system and maintain vendor relationships.
• Ensure evidence quality, perform MIS, and reconcile reports.
• Maintain ethics and compliance during investigations; analyze utilization data.
• Present findings to management with proposed cost-saving improvements.
• Identify malpractices and escalate grievances; file police complaints when required.

Connaissances

Graduation

Excel

Computer literacy

Formation

BAMS

BHMS

BPT

BDS

Outils

MS Excel

Description du poste

Deputy Manager - Risk and Loss Mitigatio...

HDE/JC/17837

• HDFC ERGO General Insurance
• India>South>Karnataka>Bangalore>Bangalore - MG Road>Bangalore - MG Road>4207>Corporate

Posted On 10 Sep 2026

End Date 10 Sep 2027

Required Experience 0 - 5 years

Basic Section

New Job Title Deputy Manager - Risk and Loss Mitigation

No. Of Openings 1

Grade JM2

Campus/Non Campus Non Campus

Employment Type Permanent

Organisational

Company HDFC ERGO General Insurance

Legal Entity HDFC ERGO General Insurance

SBU/ Channel Enabling Function

Business Function Non Sales

Cost Center Risk and Loss Mitigation

Cost Center Code 1671

Department Risk and Loss Mitigation

Function Risk and Loss Mitigation

Business Zone NA

Job Role Team Member

Country India

Region South

Physical Branch Bangalore - MG Road

Branch Code 4207

Type of Office Corporate

Skills

Skill

Graduation

CERTIFICATION

Working Language

Job Description

Physical field Investigation of claim assigned through system.

Handling physical verification, field visits to hospitals, pharmacies, diagnostic centers etc, collect evidences and report for further action to Insurers, Corporates etc.

Preparing reports based on findings and observations and guide / Gathering and Analyzing the facts and developing & creating evidence which stands in court of law

Report submission in CIMA (In house system that is being used for Investigation)

Maintain healthy and cordial relationship with hospitals and TPA desk.

Ascertain evidence quality as per matrix Validate each & every evidence with the case triggers

MIS preparation and report reconciliation

Ensure the ethics and compliance while investigating a claim

Analyze data on utilization, outcomes to determine trends and identify problem areas.

Present findings to the management, which may include reviews, proposed solutions, and implementation of long- and short-term solutions for improvements in claim processing and cost savings.

Identification of Hospitals / individuals involved in malpractices to create database

Escalation & Grievance Management for the investigated cases

Filing of police complaints and liaising with the police authorities for taking necessary action against fraudulent individuals / hospital and others

Required Qualifications:

Medical Graduates such as BAMS/BHMS/BPT or BDS with working experience of Health insurance industry preferably with Claims investigation/ processing experience

Excel and computer