Key Responsibilities
- Register eligible patients under the Arogyasree Scheme through the designated portal.
- Verify patient eligibility, Aadhaar details, ration card, and other required documents.
- Coordinate with consultants to obtain clinical details required for pre-authorization.
- Prepare and submit pre-authorization requests with complete documentation.
- Follow up with Arogyasree authorities for approvals, clarifications, and enhancements.
- Coordinate with nursing, medical records, billing, and diagnostic departments for timely submission of required documents.
- Ensure treatment is initiated only after obtaining the necessary approvals, except in emergency cases as per guidelines.
- Prepare and submit discharge summaries, operative notes, investigation reports, and claim documents.
- Submit claims within the prescribed timelines and follow up until settlement.
- Monitor claim status, pending cases, rejections, deductions, and resubmissions.
- Counsel patients and attendants regarding scheme benefits, eligibility, covered procedures, and documentation requirements.
- Maintain accurate records, registers, and MIS reports related to approvals, claims, settlements, and pending cases.
- Ensure compliance with Arogyasree guidelines, NABH standards, and hospital SOPs.
- Coordinate during audits and inspections conducted by Arogyasree authorities.
Required Skills
- Thorough knowledge of the Arogyasree Scheme and government healthcare programs.
- Familiarity with pre-authorization and claim processing.
- Understanding of medical terminology and clinical documentation.
- Knowledge of Hospital Information Systems (HIS).
- Proficiency in MS Office (Word, Excel, Outlook).
- Strong communication, coordination, and documentation skills.
- Ability to work under strict timelines.
Pay: ₹15,000.00 - ₹25,000.00 per month
Benefits:
- Food provided
- Health insurance
- Leave encashment
- Paid sick time
- Provident Fund
Work Location: In person
