Hospital Insurance Executive

Department: Insurance

Job Summary:

The Insurance Coordinator is responsible for managing all aspects of patient insurance processes, including verification, preauthorization, documentation, claims submission, and follow-up. The role ensures smooth coordination between patients, insurance companies, and hospital departments to facilitate timely and accurate claim settlements.

Key Responsibilities:

• Insurance Verification & Preauthorization:
• Verify patients insurance coverage, eligibility, and policy details before admission or treatment.
• Obtain preauthorization from insurance providers for procedures, surgeries, and inpatient admissions.
• Documentation & Coordination:
• Ensure all required patient and clinical documents are complete and accurately submitted to the insurer.
• Liaise with consultants, doctors, and billing departments for clarification and supporting documents.
• Claims Management:
• Prepare and submit insurance claims within the specified timelines.
• Track claim status and follow up with insurance companies to resolve pending or denied claims.
• Patient Communication:
• Explain insurance processes, coverage limits, and exclusions to patients and their families.
• Assist patients with queries regarding insurance approvals and claim settlements.
• Compliance & Reporting:
• Maintain accurate records of insurance correspondence and claim logs.
• Ensure compliance with hospital policies, TPA (Third-Party Administrator), and regulatory requirements.
• Generate daily, weekly, and monthly insurance reports for management review.

Qualifications & Skills:

• Bachelors degree in Hospital Administration, Commerce, or related field.
• 1 to 3 years of experience in hospital insurance or billing department preferred.
• Good knowledge of health insurance procedures, TPAs, and claim documentation.
• Strong communication and coordination skills.

Job Type: Full-time

Pay: ₹8,848.49 - ₹350,000.00 per month

Benefits:

• Flexible schedule
• Leave encashment
• Paid time off

Work Location: In person