Hospital Network Partnerships Lead

AIA; Kuala Lumpur; On-site; MYR 90,000 - 150,000; Full time

Job summary

AIA Shared Services is seeking a Medical Officer to act as the primary liaison between AIA/AHS and panel hospitals, ensuring cost containment, claims coordination, and service excellence. The role emphasizes fraud detection and supporting digital transformation within hospital settings.

The candidate will build relationships with hospital doctors and management, monitor costs, verify medical necessity with claims teams, and drive process improvements to enhance customer outcomes across Asia.

Qualifications

• MBBS or equivalent medical degree with full registration.
• Minimum 3 years of clinical experience, preferably in private hospital settings.
• Strong interpersonal and communication skills; confident and outspoken.
• Ability to build rapport with hospital stakeholders and collaborate.
• Analytical mindset with attention to detail in claims and billing practices.
• Problem-solving and proactive approach; able to work independently and with internal teams.
• Familiarity with insurance/TPA operations is an added advantage.
• Willingness to be based at or travel frequently to assigned hospitals.

Responsibilities

• Relationship Management: Build and maintain relationships with hospital management, doctors, and medical staff; act as liaison between AIA/AHS and panel hospitals; engage with hospital administrators to review service quality and cost efficiency.
• Cost Management: Monitor treatment costs and billing practices; verify medical necessity with claims team; educate hospital staff on policies and guidelines.
• Fraud Detection & Risk Management: Identify potential fraud; conduct audits on high value claims; mitigate risks with the fraud investigation team.
• Claims Handling: Support fast-tracking of urgent claims; mediate disputes; guide policyholders on procedures and documentation.
• Operational Efficiency & Process Improvement: Provide feedback on hospital operational challenges; assist in digital initiatives like e-claims processing and cashless systems.

Education

MBBS or equivalent

Job description

AIA Shared Services is seeking a Medical Officer to act as the primary liaison between AIA/AHS and panel hospitals, ensuring cost containment, claims coordination, and service excellence. The role emphasizes fraud detection and supporting digital transformation within hospital settings.

The candidate will build relationships with hospital doctors and management, monitor costs, verify medical necessity with claims teams, and drive process improvements to enhance customer outcomes across Asia.