Medical Advisory, Case & Fraud Management, Specialist
AIA
Pre-certification and hospitalization review
Fraud waste and abuse analysis
Cost savings benchmark achievement
The role is responsible for performing pre-certification and reviewing hospitalization cases to ensure cost containment without compromising care quality
Job Summary
The role is responsible for performing pre-certification and reviewing hospitalization cases to ensure cost containment without compromising care quality.
Candidates will lead the team in managing rostering, overtime, and headcount while ensuring guarantee letters are issued accurately within targeted turnaround times.
The position involves leading fraud, waste, and abuse initiatives by conducting robust analysis and mentoring staff in decision-making processes.
Matching Summary
The role is responsible for performing pre-certification and reviewing hospitalization cases to ensure cost containment without compromising care quality.