Manager - Risk and Loss Mitigation

HDFC ERGO General Insurance; Lucknow; In loco; INR 600.000 - 900.000; Tempo pieno

Descrizione del lavoro

HDFC ERGO General Insurance in Lucknow seeks a Manager - Risk and Loss Mitigation to oversee physical investigations of insurance claims. You will verify evidence, conduct field visits to hospitals and diagnostic centers, and report findings to insurers and corporates.

The role demands rigorous evidence gathering, compliance, and data-driven decision making. The position requires medical graduates with exposure to health insurance claim processes and strong Excel skills.

Competenze

• 0–6 years of experience in risk/claims investigation or loss mitigation preferred.
• Experience in health insurance claims investigation/processing is advantageous.

Mansioni

• Physical field investigation of claims assigned through system.
• Conduct field visits to hospitals, clinics, labs; collect evidences and report to insurers/ corporates.
• Prepare reports based on findings and guide action; ensure evidence aligns with case triggers.
• Submit MIS reports and reconcile data; maintain ethics and compliance in investigations.
• Build and maintain relationships with hospitals and TPA desks; liaise with authorities as needed.
• Identify fraud indicators, escalate grievances and assist in police liaison when required.

Conoscenze

Graduation

Formazione

Medical graduates (BAMS/BHMS/BPT/BDS)

Strumenti

Excel

Descrizione del lavoro

• India>North>Uttar Pradesh>Lucknow>Lucknow>Lucknow>1101>Corporate

Posted On 16 Sep 2026

End Date 16 Sep 2027

Required Experience 0 - 6 years

Basic Section

New Job Title Manager - Risk and Loss Mitigation

No. Of Openings 1

Grade M

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 North

City Lucknow

Physical Branch Lucknow

Branch Lucknow

Branch Code 1101

Type of Office Corporate

Skills

Skill

Graduation

CERTIFICATION

Working Language

Job Description

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