Insurance Coordinator

Insurance Coordinator

Key Responsibilities

A. Patient Admission & Initial Assessment

• Attend to insurance/TPA patients at admission or OP referral
• Verify eligibility, policy validity, sum insured, and coverage
• Explain the insurance process, room eligibility, and exclusions
• Collect and verify documents (ID, insurance card, Aadhaar, PAN, medical records)

B. Pre-Authorisation & Approval Process

• Prepare and submit pre-authorisation requests
• Coordinate with doctors for diagnosis, treatment, and clinical notes
• Obtain cost estimates and upload documents
• Follow up for approvals within TAT
• Handle queries, rejections, and enhancements

C. Coordination & Communication

• Act as liaison between patients, doctors, billing, and insurers
• Ensure real-time communication for approvals and discharge planning

D. Discharge & Final Approval

• Collect the final bill and medical documents
• Submit for final approval on time
• Explain deductions and patient liability
• Handle reconsideration and deposit collection

E. Post-Discharge & Claim Settlement

• Submit final claim documents within the timelines
• Track payments and follow up
• Maintain settlement records

F. Government Schemes Handling

• Process CGHS, ESIC, MEDISEP, PMNR, and special schemes
• Ensure compliance and portal uploads

G. Documentation and account management

• Maintain physical and digital records
• Update Excel/MIS trackers
• Ensure audit readiness

3. Authority & Accountability

• Coordinate with insurers on behalf of the hospital
• Ensure accuracy and timeliness
• Minimise claim rejections and discharge delays

4. Skills & Competencies Technical Skills

• Insurance & TPA workflows
• CGHS, ESIC, MEDISEP knowledge
• Portal handling
• MS Excel, HIS

Soft Skills

• Communication & interpersonal skills
• Patient counseling
• Time management
• Attention to detail

5. Qualifications & Experience

• Education: Graduate (Commerce/Science/Hospital Administration preferred)
• Experience: 2 years or more in hospital insurance

Job Type: Full-time

Pay: ₹18,000.00 - ₹20,000.00 per month

Benefits:

• Cell phone reimbursement
• Health insurance
• Provident Fund

Education:

• Bachelor's (Preferred)

Language:

• Hindi & English (Preferred)

Location:

• Thrissur, Kerala (Preferred)

Work Location: In person