Dr. Santosh Kumar S
BDS, MBA, FIII.
Chennai, Tamil Nadu, India
Executive Summary
Accomplished healthcare executive with dual expertise in dental practice and insurance administration. MBA graduate from Birla Institute of Technology and Science, Pilani specialized in health systems strategic management with over 10+ years of progressive experience spanning clinical practice, medical administration, and insurance operations.
Currently serving as National Head of Investigation and Fraud Mitigation at Cholamandalam MS General Insurance, overseeing health, accident, and travel claims verification across India. Previously held increasingly responsible leadership positions at Star Health and Allied Insurance, culminating in Division Head role.
Holds Fellowship from the Insurance Institute of India with additional credentials in clinical research and pharmacovigilance from James Lind Institute. Pursuing further education in actuarial science through the Institute and Faculty of Actuaries to enhance analytical capabilities in risk assessment and financial modeling for insurance products.
Key Achievements:
At Cholamandalam MS General Insurance, implemented AI-based fraud detection system that reduced fraudulent claims by 28% and saved approximately ₹3.4 crore ($410,000 USD / £325,000) annually.
Led network expansion at Star Health and Allied Insurance, onboarding 3000+ hospitals across South India, improving claim settlement time by 35%.
Developed Automated new claims processing workflow at Star Health, reducing approval turnaround time from 4 hours to 190 milliseconds while maintaining 99.2% accuracy.
Developed and implemented healthcare pricing strategy at Star Health that optimized reimbursement rates and reduced payment disputes by 40%.