Pre-Authorization & Verification
- Eligibility Checks: Verify a patient’s health insurance policy details and coverage scope before admission or treatment.
- Pre-Authorizations: Coordinate with Third-Party Administrators (TPAs) and insurers to secure cashless approvals for planned and emergency procedures.
Patient Counseling & Support
- Benefit Explanations: Educate patients on their insurance coverage, co-pays, sub-limits, and potential out-of-pocket expenses.
- Dispute Resolution: Address patient queries regarding denied claims, delayed approvals, or unexpected billing issues.
Claims Management & Billing
- Documentation: Ensure all medical charts, ICD/procedure codes, and itemized bills are accurately prepared for insurers.
- Claim Submission: Submit finalized claims and follow up persistently to ensure timely reimbursement.
Denial Management & Compliance
- Appeals: Handle claim rejections by submitting necessary appeals, additional medical records, and justifications.
- Compliance: Ensure all billing and insurance operations adhere to healthcare regulations and hospital policies.
Pay: ₹20,000.00 - ₹25,000.00 per month
Work Location: In person
