ob Title: Mediclaim ExecutiveDepartment: TPA / Insurance / BillingLocation: [Hospital Name]Reports To: Billing Manager / TPA HeadJob Summary:
The Mediclaim Executive is responsible for handling insurance and cashless claims, coordinating with TPAs and insurance companies, ensuring timely approvals, and smooth processing of patient billing under insurance.
Key Responsibilities:
- Handle cashless and reimbursement claims for patients
- Coordinate with TPA/Insurance companies for approvals and queries
- Verify patient insurance eligibility and policy details
- Prepare and submit pre-authorization and final bills
- Follow up for claim approvals, denials, and settlements
- Maintain proper documentation and records of all claims
- Explain insurance process and coverage to patients/relatives
- Resolve claim-related issues and discrepancies
- Ensure compliance with hospital and insurance guidelines
- Coordinate with billing, doctors, and nursing staff for required documents
Required Skills:
- Knowledge of Mediclaim / TPA processes
- Good communication and coordination skills
- Basic knowledge of medical terminology
- Computer proficiency (Hospital Software, MS Excel)
- Attention to detail and documentation accuracy
Qualifications:
- Graduate (Any field)
- Experience in hospital billing / TPA / insurance preferred (1–3 years)
Key Performance Indicators (KPIs):
- Timely claim submission and approval rate
- Reduction in claim rejections/denials
- Accuracy in documentation and billing
- Patient satisfaction in insurance handling
if interested then contact us at [email protected] & Whatsapp.-9316992411
Thanx,
HR Team
Pay: ₹10,000.00 - ₹20,000.00 per month
Benefits:
- Health insurance
- Provident Fund
Work Location: In person
