Insurance Officer cum Billing Executive

Job Summary

The Insurance Officer cum Billing Executive is responsible for handling all inpatient/outpatient insurance operations, coordinating with TPAs/insurance companies, preparing accurate bills, managing approvals, and ensuring smooth discharge and claim processing.

⸻

Key Responsibilities

1. Insurance Operations

• Verify insurance eligibility and coverage for all patients.

• Collect necessary documents from patients for insurance processing.

• Submit pre-authorization (pre-auth) requests and follow up with TPAs/insurance companies.

• Monitor approval status, enhancements, and queries.

• Explain insurance terms, co-payments, and non-payable items to patients/attenders.

• Assist doctors and departments to complete required supporting documents.

2. Billing Responsibilities

• Prepare interim and final bills for inpatient (IP) and outpatient (OP) services.

• Ensure accurate posting of all charges: room, pharmacy, lab, radiology, procedures, doctor visits, consumables, etc.

• Check for missing charges and coordinate with departments before final billing.

• Prepare separate insurance bills and patient-payable bills according to TPA guidelines.

• Coordinate with discharge team to ensure smooth and timely patient discharge.

3. Cash Handling (if applicable)

• Collect co-payments, non-payable items, and any balance amounts from patients.

• Issue receipts and maintain accurate transaction records.

• Hand over daily cash collection to accounts/finance.

4. TPA / Insurance Coordination

• Maintain regular communication with TPAs and insurance officials.

• Submit required documents for final authorization.

• Resolve queries and respond to TPA clarifications promptly.

• Ensure timely submission of insurance claims for reimbursement.

• Track claim status and follow up on pending or rejected claims.

5. Documentation & Compliance

• Maintain complete insurance files—pre-auth, approvals, bills, claim forms, discharge summaries, invoices.

• Ensure all documentation is as per insurance guidelines.

• Support internal/external audit processes.

• Maintain confidentiality of patient and financial information.

Skills & Competencies

• Strong knowledge of hospital insurance & billing processes

• Familiar with TPA guidelines and claim workflows

• Good communication & negotiation skills

• Ability to handle pressure during discharge hours

• Basic accounting and billing knowledge

• Proficient in HIS/billing software and MS Office

Qualification & Experience

• Education: B.Com, BBA, Diploma in Hospital Administration, or similar

• Experience: 1–4 years in hospital insurance desk or billing

• Technical: Hands-on experience with hospital billing software

Location : No-18, Ramachandra Iyer Street, Nehru Nagar, Chromepet, Chennai, Tamil Nadu, 600044

Call or Whatsapp : 9-7-3-1-6-1-3-3-6-2

Job Type: Permanent

Pay: ₹20,000.00 - ₹25,000.00 per month

Benefits:

• Paid time off
• Provident Fund

Education:

• Diploma (Required)

Work Location: In person