Insurance Executive

Purpose of the Role

To manage insurance, TPA, and cashless processes efficiently, ensuring timely approvals, accurate billing, and smooth coordination between patients, TPAs, insurance companies, and hospital departments.

Key ResponsibilitiesInsurance & TPA Coordination

• Handle cashless approvals with TPAs and insurance companies
• Coordinate for pre-authorization, enhancement, and final approval
• Liaise with TPAs/insurance desk for queries and clarifications

Billing & Documentation

• Collect, verify, and submit insurance documents accurately
• Ensure correctness of patient files, estimates, and discharge summaries
• Coordinate with billing team for insurance billing and claims submission

Claims Processing

• Track insurance claims from submission to settlement
• Follow up with TPAs/insurers for pending claims and payments
• Resolve claim rejections, deductions, and discrepancies

Patient & Attendant Support

• Explain insurance procedures, coverage, and exclusions to patients
• Support patients during admission and discharge for insurance formalities
• Address insurance-related queries professionally

Compliance & Records

• Maintain proper insurance files and records
• Ensure compliance with hospital policies and insurance guidelines
• Support audit, NABH, and internal reviews

Coordination & Communication

• Coordinate with doctors, nursing, billing, and finance departments
• Maintain updated contact list of TPAs & insurance companies
• Ensure smooth information flow across departments

Job Type: Full-time

Pay: ₹10,000.00 - ₹15,000.00 per month

Benefits:

• Paid time off

Work Location: In person