Key Responsibilities
1. Patient Admissions & Cashless Processing
- Guide patients through the health insurance claim process.
- Review policy details and verify coverage eligibility for planned and emergency admissions.
- Submit pre-authorization requests to TPAs/insurance companies and follow up for timely approvals.
2. Coordination & Liaison
- Serve as the main point of contact between treating doctors, hospital staff, and the insurance company.
- Communicate claim statuses, pending requirements, and approvals to patients' families.
3. Billing & Documentation
- Manage inpatient billing and ensure all medical files,
- reports, and bills are accurately compiled.
4. Claim Settlement & Follow-Up
- Maintain follow-ups with insurance companies to clear pending or rejected claims.
- Track outstanding payments and ensure the hospital's credit terms are met.
- Handle TPA portals and maintain digital/physical records of all transactions.
Requirements
- Education: Bachelor's degree in any discipline; BCom, BBA, or a degree in Hospital Administration (MHA) is highly preferred.
- Experience: Typically requires 1 to 3 years of hands-on experience in healthcare billing, TPA operations, or insurance coordination.
- Reconcile final bills, implants, and split-billing (e.g., separating doctor charges) according to TPA norms.
- Submit physical and digital copies of patient medical files and discharge summaries to insurers.
Pay: ₹10,076.09 - ₹32,506.53 per month
Work Location: In person
