Senior Consultant Job at EY
Looking for a Senior Consultant Job where your medical expertise can make a real impact? EY Careers has announced an exciting opportunity for MBBS professionals to join its Forensics, Investigations & Compliance team in Gurugram. Among the latest Medical Jobs India opportunities, this role focuses on healthcare fraud management, medical audits and claims review. Candidates with 3–6 years of relevant experience can explore this career opportunity at EY
About EY:
EY is a global leader in assurance, tax, transaction, and advisory services, dedicated to building a better working world. The organization emphasizes a culture of training, opportunities, and creative freedom, ensuring that employees can develop their skills and careers. EY’s commitment to its workforce is reflected in its belief that potential is limitless, and it strives to provide motivating and fulfilling experiences that help individuals become their best professional selves. The PKP, “EY careers,” is central to the opportunities available within the organization.
Job Details:
- Location: Gurugram
- Other locations: Primary Location Only
- Salary: Competitive
- Date: 17 August 2026
- Requisition ID: 1736278
Job Description:
The Senior Consultant role within EY’s Forensics, Investigations & Compliance team involves supporting Fraud, Waste & Abuse (FWA) management initiatives under government-funded health insurance and healthcare schemes. The position will leverage clinical expertise and data-driven approaches to strengthen scheme integrity. Key responsibilities include developing fraud detection mechanisms, conducting clinical audits of claims, and providing technical support to claims adjudication processes.
Key Responsibilities:
- Conduct desk-based medical audits and reviews of claims submitted under government healthcare schemes.
- Identify indicators of fraud, waste, and abuse, including inappropriate billing and documentation inconsistencies.
- Support development, refinement, and validation of fraud detection triggers and control mechanisms.
- Assess the clinical appropriateness of diagnoses and procedures against established treatment protocols.
- Provide clinical insights to strengthen claims adjudication and fraud management processes.
- Support investigation and resolution of potentially suspect claims.
- Collaborate with stakeholders to support fraud control initiatives.
- Prepare audit observations and analytical reports.
Eligibility Criteria for this Senior Consultant Job:
- Essential: MBBS from a recognized Indian university/institution (FMGs will not be considered).
- Desirable: MD or Postgraduate Medical Qualification from a recognized university/institution.
- 3 to 6 years of experience in medical audits, claims review, or healthcare fraud management preferred.
Required Skills for this Senior Consultant Job:
- Ability to work collaboratively across multiple client departments.
- Practical problem-solving skills with the ability to deliver insightful solutions.
- Agility, curiosity, and adaptability in approach.
- Strong communication skills to engage with various stakeholders.
