Designation: Insurance Executive
Department: Insurance / TPA Department
Reports To: Insurance Manager / Hospital Administrator
Job Summary
The Insurance Executive is responsible for coordinating with insurance companies and TPAs, processing cashless approvals, handling patient insurance documentation, claim submissions, and ensuring timely settlement of insurance claims.
Key Responsibilities
- Process cashless hospitalization requests and obtain approvals.
- Coordinate with insurance companies and TPAs for claim processing.
- Verify patient insurance eligibility and policy coverage.
- Collect and scrutinize insurance documents.
- Submit pre-authorization, enhancement, and final claim documents.
- Follow up on pending approvals, claims, and settlements.
- Maintain insurance records and claim status reports.
- Coordinate with billing, nursing, MRD, and accounts departments.
- Resolve insurance-related patient queries and grievances.
- Ensure compliance with hospital and insurance guidelines.
Qualification
- Any Degree (B.Com, BBA, B.Sc, BA, or equivalent)
- Diploma/Certification in Hospital Administration or Health Insurance preferred.
Experience
- Fresher to 2 years – Insurance Coordinator/Executive
- 2–5 years – Insurance Executive
- 5+ years – Senior Insurance Executive / Insurance In-Charge
Skills Required
- Knowledge of TPA and insurance claim procedures
- Hospital billing and documentation knowledge
- MS Excel and Hospital Information System (HIS)
- Communication and negotiation skills
- Attention to detail and documentation accuracy
Salary Range (Tamil Nadu)
Pay: ₹18,075.81 - ₹52,509.61 per month
Benefits:
- Cell phone reimbursement
- Food provided
- Internet reimbursement
- Leave encashment
- Life insurance
- Provident Fund
Work Location: In person
