About the role
Key Roles & Responsibilities Lead and manage a team of Bima Saathis (BS) across multiple states. Conduct weekly training sessions and performance reviews to enhance team capability and productivity. Review investigation reports to ensure quality, accuracy, andtimelyclosure. Drive achievement of key KRAs, including Grade 1%, Grade 1 Value, TAT, and Productivity. Identifyfraud trends, suspicious activities, and nexus between providers, policyholders, and other stakeholders. Implementdeterrence measures in fraud-prone geographies and networks. Coordinate and file police complaints/FIRs in fraud cases and liaise with law enforcement agencies. Collaborate with internal stakeholders to strengthen fraud risk mitigation and improve investigation outcomes. Monitor MIS, performance metrics, and provide regular updates to management on team performance and fraud control initiatives. Compliance & Adherence Adherence to 100% compliance Key Requirements – Education & Certification Medical Graduates such as BAMS/BHMS/BPT or BDS Key Requirements – Experience & Skills Work experience of 7-8 years in Health insurance industry Or Non-Medico with Insurance experience of Min 10 years. Excel and computer knowledge