Hospital Network Partnership, Specialist
Core
Key liaison between AIA/AHS and panel hospitals to manage relationships, control costs, detect fraud, and coordinate claims.
Role type
Specialist Medical Officer (Hospital Network Partnership)
Builds
Hospital network partnerships and claims processing workflows
Domain
Health Insurance / Hospital Administration
Deliverable
client delivery
Required skills
Medical degree (MBBS), clinical experience, relationship management, cost analysis, fraud detection, claims coordination, process improvement
Preferred skills
Familiarity with insurance/TPA operations
Responsibilities
Build and maintain relationships with hospital management and specialist doctors; Monitor treatment costs and billing practices to ensure cost containment; Identify and report suspicious billing patterns or potential fraud; Support fast-tracking of urgent and high-priority claims; Provide feedback on hospital operational challenges to optimize performance