Specialist in Combating Insurance Fraud (BVM)
KPT Krankenkasse AG
Bern und Homeoffice
Key information
- Publication date:04 September 2025
- Workload:100%
- Contract type:Unlimited employment
- Place of work:Bern und Homeoffice
Job summary
Join KPT, one of the top ten health insurers in Switzerland! Make a difference in healthcare efficiency and fairness.
Tasks
- Identify cases of abuse and unnecessary costs to protect KPT's interests.
- Negotiate with claimants and lawyers on complex economic issues.
- Collaborate with data analysts to uncover suspicious patterns using smart IT tools.
Skills
- Several years of experience in the medical field or health insurance.
- Fluent in French and very good German communication skills.
- Strong Excel and data analysis proficiency.
Is this helpful?
The Benefits and Efficiency Control team ensures that services are provided and billed correctly, legally compliant, and efficiently – with a watchful eye on fairness and abuse. Do you recognize patterns that others miss, switch effortlessly to French, and want to make the healthcare system a little fairer?
What you can achieve
- You uncover cases of abuse and unnecessary costs while representing the economic interests of KPT.
- You negotiate confidently with beneficiaries and lawyers and clarify complex questions around efficiency and insurance fraud.
- Your network is your tool: you maintain sustainable contacts internally and externally – up to committees where you competently represent KPT.
- Together with our data analysts, you systematically track down suspicious constellations – supported by smart IT tools.
- You also contribute strategically and further develop our efficiency control.
What distinguishes you
- Several years of professional experience in the medical environment or benefits area of a health insurance company
- Solid knowledge of medical terminology
- Fluent French in spoken and written form is a requirement – very good oral German skills
- Target group-oriented communication skills combined with assertiveness
- Proficient in Excel and data analysis
Your benefits
- 40-hour week and flexible working hours
- Home office options
- 25 vacation days, 30 days from age 50
- December 24th & 31st paid holidays
- 15 minutes paid breaks each morning and afternoon
- Free fruit
- Diverse drink and food offerings in the in-house cafeteria
- Modern office spaces directly at Wankdorf Bern train station
- CHF 300.– rail coupon for an annual, route, or general subscription (GA)
- CHF 2,200.– Reka checks per year with a 20% discount
KPT is one of the ten largest health insurance companies in Switzerland. The satisfaction of our customers is our success.