Insurance Executive – Multi-Centre Oncology Network
Job Title: Insurance Executive
Location: Chennai (with travel across centres as required)
Department: Operations / Revenue Cycle Management
Reports To: Regional Operations Manager / Centre Head
About the Role
The Insurance Executive will be responsible for managing all insurance-related processes across multiple oncology day-care centres, ensuring timely pre-authorizations, claims processing, approvals, documentation, coordination with TPAs and insurance companies, and maximizing claim realization while maintaining compliance and patient satisfaction.
Key Responsibilities
Insurance Coordination & Patient Support
- Manage insurance, corporate, government scheme, and TPA cases across multiple centres.
- Educate patients and caregivers regarding insurance eligibility, coverage, exclusions, and required documentation.
- Guide patients through cashless and reimbursement claim processes.
- Coordinate with treating doctors, nursing teams, pharmacy, and billing departments to ensure complete documentation.
Pre-Authorization Management
- Submit pre-authorization requests for chemotherapy, supportive care, investigations, and related oncology treatments.
- Follow up with insurance companies and TPAs for approvals and clarifications.
- Ensure approvals are obtained before treatment initiation wherever required.
- Track approval turnaround times and escalate delays.
Claims Processing
- Prepare and submit complete claim documentation.
- Verify policy details, treatment eligibility, package approvals, and coverage limits.
- Coordinate claim submissions for both cashless and reimbursement cases.
- Ensure timely claim filing to minimize rejections.
Denial Management & Recovery
- Analyze claim rejections, deductions, and queries.
- Coordinate appeals and resubmissions.
- Work with insurance companies and TPAs to maximize claim recovery.
- Maintain records of deductions and identify recurring rejection patterns.
Multi-Centre Operations
- Monitor insurance cases across all assigned centres.
- Support front-office teams in insurance-related workflows.
- Standardize insurance documentation processes across centres.
- Train centre staff on documentation requirements and insurance workflows.
- Travel periodically to centres for audits and process improvement initiatives.
Documentation & Compliance
- Maintain complete insurance records and approval documentation.
- Ensure compliance with insurer, TPA, hospital, and regulatory requirements.
- Support internal and external audits.
- Ensure confidentiality of patient information and compliance with applicable data privacy regulations.
Qualifications
- Bachelor's Degree in Commerce, Business Administration, Healthcare Management, Life Sciences, or related field.
- Certification in Health Insurance/Medical Insurance processes preferred.
Experience
- 2–5 years of experience in hospital insurance operations, TPA coordination, or medical claims processing.
- Experience in oncology, multi-specialty hospitals, or day-care centres preferred.
- Experience handling multiple insurance providers and TPAs.
- Experience working across multiple locations/branches is an advantage.
Required Skills
- Strong knowledge of health insurance and TPA processes.
- Understanding of cashless and reimbursement claim workflows.
- Excellent follow-up and negotiation skills.
- Strong documentation and analytical abilities.
- Proficiency in MS Excel and hospital management systems.
- Ability to work independently and manage multiple centres simultaneously.
- Excellent communication skills in English and Tamil.
Pay: ₹25,000.00 - ₹40,000.00 per month
Benefits:
Work Location: In person
