Deputy Manager

Key Responsibilities –

• Conduct field and desk medical audits, with a view to detecting any suspicious activity and highlighting the same to concerned SHAs in a timely manner.
• Create and strengthen medical audit tools, guidelines, training content and modules to conduct effective desk and field medical audits.
• Preparation of audit reports with key findings and following up with various stakeholders for closure of action.
• Analyze various dashboards, triggers, and outliers, to identify cases for medical audit.
• Analyze data trends, dashboards and suspect cases referred from triggers and/or identified from other sources.
• Work closely with the IT Team to embed fraud triggers, medical protocols, guidelines, and medical audit requirements (both concurrent and post facto) into the system
• Capacity building of States in medical audit and field investigation.
• Conduct joint field medical audits along with State teams.
• Conduct daily IP bill audit before patients discharges and ensure audit findings are corrected before discharges.
• Conduct perpetual stock audit / cash audit on sample basis.
• Conduct surprise audit in different Ares’s of the hospital with prior approval of finance head / FD.
• Audit of discount, bills Cancellation, un-billing of services , and other reports on weekly / fortnight basis.
• Any other work that may be assigned by management from time to time.