Job Description: Assistant Manager - Operations

Role Overview
- Job Title: Team Lead / Assistant Manager - Enforcement (Field Role)
- Department: Provider Partnerships
- Employment Type: Full time

Position Summary

The Team Lead / Assistant Manager - Enforcement will play a critical role in ensuring

financial integrity and compliance across our provider network. This is a dynamic, field
- oriented leadership role where you will investigate suspicious claims, negotiate billing

blends deep clinical/billing knowledge with strong negotiation skills to protect business

interests while maintaining healthy partnership ecosystems.

Key Responsibilities

1. Claims Review & Forensic Analysis
- Critically review and analyze flagged medical claims to identify instances of

overbilling, fraud, waste, abuse (FWA), or deviations from contractual tariffs.
- Document investigative findings, trends, and claim discrepancies with high precision

and audit-ready clarity.

2. Hospital Engagement & Dispute Resolution




- Act as the primary point of contact for hospital billing teams and treating physicians

to communicate, negotiate, and resolve billing discrepancies.
- Conduct targeted hospital field visits to resolve complex disputes, audit on-site

records, and drive positive provider engagement.
- Ensure swift, structured settlement of overcharged claims and maintain meticulous

records of all hospital interactions.

3. Tracking, Governance & Reporting
- Oversee and maintain internal dashboards and trackers monitoring recoveries,

refunds, and adjustments.
- Formally handle escalations, issuing official communications or show-cause notices

to non-compliant providers when necessary.
- Provide strategic, data-driven updates to senior management on enforcement progress

and recovery targets.

Requirements & Qualifications

Education
- Preferred: Bachelor’s or Master’s degree in Healthcare Administration, Hospital

Management, Nursing, or Clinical streams (BDS, BHMS, and BAMS).

Exper

📌 Assistant Manager (B.B.D. Bagh)
🏢 MEDI ASSIST INSURANCE TPA PRIVATE
📍 B.B.D. Bagh