Job Title: Insurance Executive
Department: Insurance / TPA
Industry: Hospital
Experience: Minimum 2 years of experience in hospital insurance
Salary: Based on experience and qualifications
Key Responsibilities
- Handle cashless hospitalization and reimbursement insurance processes.
- Coordinate with insurance companies and TPAs for pre-authorizations and claim approvals.
- Verify patient insurance eligibility and policy coverage.
- Prepare and submit pre-authorization requests with accurate documentation.
- Follow up on pending approvals, queries, and claim settlements.
- Ensure accurate documentation of insurance records and patient files.
- Coordinate with consultants, nursing staff, billing, and medical records for required documents.
- Process discharge approvals and ensure timely claim closure.
- Address patient and attendant queries regarding insurance coverage and claim procedures.
- Maintain daily MIS reports of insurance cases, approvals, rejections, and pending claims.
- Ensure compliance with hospital policies, insurance guidelines, and regulatory requirements.
- Support internal and external audits related to insurance documentation.
Qualifications
- Bachelor's Degree in any discipline
- Minimum 2 years of experience in hospital insurance
- Knowledge of cashless claims, reimbursement claims, insurance policies, and TPA procedures.
- Proficiency in Hospital Information Systems (HIS) and MS Office.
Pay: ₹20,000.00 - ₹30,000.00 per month
Work Location: In person
