Join a global leader in professional services, dedicated to fostering a culture of continuous growth and development. We believe in empowering our people with the training, opportunities, and creative freedom to excel.

This role is part of our National Forensics team, focusing on Investigations & Compliance within government-funded healthcare and insurance schemes. Our Forensic & Integrity Services professionals are crucial in protecting and restoring enterprise and financial reputations. We partner with organizations and legal counsel to investigate, resolve disputes, and manage regulatory challenges, reinforcing integrity at the core of compliance programs.

Our integrated approach enhances areas of perceived weakness, including governance, controls, and data insights, to full organizational design and implementation, ultimately helping companies safeguard their financial and brand reputations and build trust in capital markets worldwide.

In this impactful role, you will leverage clinical expertise and data-driven methods to support Fraud, Waste & Abuse (FWA) management initiatives. Key responsibilities include conducting medical audits of claims, validating fraud detection mechanisms, and providing technical support for claims adjudication processes.

You will identify indicators of fraud, waste, and abuse by examining billing practices, procedure appropriateness, documentation, and claim patterns. Your work will involve assessing the clinical validity of diagnoses and treatments against established protocols and scheme guidelines.

Further responsibilities include supporting investigations, collaborating with scheme authorities and internal teams, delivering capacity-building sessions, and preparing comprehensive audit observations and analytical reports. You will also contribute to enhancing fraud prevention and control mechanisms across healthcare schemes.

To be successful in this role, you must hold an MBBS degree from a recognized Indian university. Foreign Medical Graduates (FMGs) will not be considered.

We are particularly interested in candidates with experience in clinical practice, hospital operations, medical audits, health insurance, public health programs, or related healthcare domains. A postgraduate medical qualification such as an MD is considered desirable.

We seek individuals who can collaborate effectively across diverse client departments while adhering to commercial and legal requirements. A practical, problem-solving approach combined with the ability to deliver insightful solutions is essential. Adaptability, creativity, and a positive, energetic mindset are key attributes we value.