Bhavdeepkumar Mangukiya

Dedicated Investigator with expertise in conducting thorough field investigations for insurance claims. Skilled in evidence collection, report generation, and legal compliance, with a strong focus on maintaining relationships and ensuring integrity in all processes. Adept at data analysis, trend identification, and implementing strategies for cost-effective claim resolution. Committed to joining a dynamic team to enhance fraud detection and prevention efforts.

DEPUTY MANAGER - RISK AND LOSS MITIGATION - HDFC ERGO General insurance - Surat

(2023-08)

• Conducted meticulous on-site investigations for assigned claims, ensuring thorough physical verification at hospitals, pharmacies, and diagnostic centers.
• Compiled robust evidence through field investigations, contributing to the development of court-admissible reports.
• Efficiently documented investigative findings in the CIMA system, enhancing case management processes.
• Fostered strong partnerships with hospital staff and TPA desks, promoting collaborative efforts in risk mitigation.
• Rigorously assessed evidence against established matrices, ensuring comprehensive validation in line with case specifics.
• Produced detailed Management Information System (MIS) reports, facilitating accurate data reconciliation.
• Upheld the highest standards of ethics and compliance during all investigative activities.
• Analyzed utilization and outcome data to identify trends and pinpoint areas of concern, driving strategic risk management.
• Delivered insightful presentations to management, outlining findings and advocating for both immediate and long-term remedial actions.
• Spearheaded the creation of a database to track malpractice incidents, aiding in the proactive identification of fraudulent activities.
• Managed case escalations and grievances, ensuring timely and effective resolution of investigated cases.
• Initiated police complaints and collaborated with law enforcement to pursue legal action against fraudulent parties.

RESIDENT MEDICAL OFFICER - Siddhi ICU And Multispeciality Hospital - Vadodara

(2022-01)

• Served as a Resident Medical Officer in the Intensive Care Unit (ICU), delivering critical care and life-saving interventions.

RESIDENT MEDICAL OFFICER - Kalavati Hospital - Vadodara

(2021-01)

• Served as a Resident Medical Officer in the COVID-19 department, ensuring high-quality patient care during critical times.
• Spearheaded ward administration, optimizing operational efficiency and healthcare delivery.

BHMS - Gujrat Homeopathic Medical collage (2023)