Key Responsibilities
- Process cashless hospitalization and reimbursement claims.
- Coordinate with TPAs, insurance companies, and CGHS authorities for pre-authorizations and claim approvals.
- Verify patient insurance eligibility, policy coverage, and required documentation.
- Prepare and submit pre-authorization requests, claim forms, and supporting medical documents.
- Follow up on pending approvals, claim settlements, and reimbursement cases. Coordinate with doctors, nursing, billing, medical records, and front office teams for claim related documentation.
- Ensure accurate documentation as per TPA, CGHS, and NABH guidelines.
- Resolve claim queries, discrepancies, deductions, and rejections within the stipulated timelines.
- Maintain records of claims, approvals, settlements, and pending cases.
- Ensure compliance with hospital policies, NABH standards, and insurance regulations. Assist patients in understanding insurance procedures and provide timely updates on claim status.
Pay: ₹30,000.00 - ₹45,000.00 per month
Work Location: In person
