Manager - Risk and Loss Mitigation

HDFC ERGO General Insurance; Nagpur District; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

HDFC ERGO General Insurance in Nagpur invites an experienced professional for the role of Manager - Risk and Loss Mitigation. You will lead investigations into potential fraud in health claims and coordinate with vendors and police where required.

The candidate should have 2-6 years of relevant experience, a graduate degree, and a proven ability to analyze data, prepare MIS reports, and escalate issues with urgency and diligence.

Qualifications

• Graduation is required.

Responsibilities

• Health claims investigation and identification of suspected cases.
• Allocation of suspected cases to vendors for investigation with triggers.
• Self-investigation of suspected fraud cases and follow-up for investigation reports.

Skills

Graduation

Job description

• India>West>Maharashtra>Nagpur>Nagpur>Nagpur>2110>Corporate

Posted On 05 Aug 2026

End Date 05 Aug 2027

Required Experience 2 - 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 Risk and Loss Mitigation

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 TM-FCI

Country India

Region West

State Maharashtra

City Nagpur

Physical Branch Nagpur

Branch Nagpur

Branch Code 2110

Type of Office Corporate

Skills

Skill

Graduation

CERTIFICATION

Working Language

Job Description

Health Claims Investigation Identification of suspected cases reported to the Company from the concerned location Allocation of suspected cases to vendors for investigation with case relevant triggers Self-investigation of suspected fraud cases Follow up for Investigation Report with vendor ensuring closure of investigation within defined TAT Level 1 QC clearance & validate the submissions against shared triggers Preparing reports based on findings and observations duly supported by strong medical & legal evidences which stands in court of law Identification of Hospitals/ individuals involved in malpractices and gathering market intelligence Escalation Management & Grievance Management for the investigated cases Maintaining proper MIS and report reconciliation Vendor Payment Reconciliation, Vendor Empanelment & Training & Development Desktop Investigation Trigger identification through data at intimation/Referral stage Data analysis with respect to the product loss ratio, Agent loss ratio, cases from suspected Hospitals and identify the adverse trend 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. Filing of police complaints and liaising with the police authorities for taking necessary action against fraudulent individuals / hospital and others