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 agile, field
oriented leadership role where you will investigate suspicious claims, negotiate billing

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

interests while maintaining healthy partnership ecosystems.

Key Responsibilities
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.
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 in office

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

records of all hospital interactions.
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 (India)
🏢 MEDI ASSIST INSURANCE TPA PRIVATE
📍 India