1–5 Years (Hospital Insurance Experience Preferred)
Education:
- Any Bachelor's Degree
- Additional certification in Health Insurance or Hospital Administration is an added advantage.
Job Summary:
The Insurance Executive is responsible for coordinating with insurance companies and Third-Party Administrators (TPAs) to ensure smooth processing of cashless and reimbursement claims. The role involves obtaining pre-authorizations, maintaining documentation, following up on approvals, and ensuring timely claim settlements while providing excellent support to patients.
Key Responsibilities:
- Process cashless and reimbursement insurance claims.
- Coordinate with TPAs and insurance companies for pre-authorizations and approvals.
- Verify patient insurance eligibility and policy coverage.
- Collect and maintain all required documents for claim processing.
- Follow up with insurance providers for pending approvals and claim settlements.
- Coordinate with doctors, nursing staff, billing, and medical records departments for required documents.
- Resolve insurance-related queries from patients and attendants.
- Ensure accurate documentation and compliance with hospital and insurance guidelines.
- Monitor rejected or pending claims and initiate corrective actions.
- Maintain daily MIS reports and insurance claim records.
- Support the billing team in insurance-related activities.
- Ensure timely closure of insurance cases and minimize claim rejections.
Required Skills:
- Knowledge of TPA and health insurance claim procedures.
- Familiarity with cashless and reimbursement processes.
- Positive communication and interpersonal skills.
- Strong documentation and organizational abilities.
- Proficiency in MS Office (Excel, Word, Outlook).
- Ability to work under pressure and meet deadlines.
- Problem-solving and coordination skills.
Preferred Qualifications:
- Experience in hospital insurance desk operations.
- Knowledge of major TPAs and insurance companies.
- Experience with Hospital Information Systems (HIS) is an advantage.
Key Competencies:
- Attention to Detail
- Customer Service Orientation
- Teamwork
- Time Management
- Effective Communication
- Integrity and Confidentiality
- Multitasking Ability
Working Conditions:
- Rotational shifts as per hospital requirements.
- May be required to work on weekends and public holidays based on duty roster.
Performance Indicators (KPIs):
- Timely processing of insurance claims.
- Reduction in claim rejections.
- Faster pre-authorization turnaround time.
- Accurate documentation and compliance.
- Patient satisfaction in insurance services.
- Timely settlement and follow-up of pending claims.
Pay: ₹16,000.00 - ₹25,000.00 per month
Benefits:
- Cell phone reimbursement
- Flexible schedule
- Provident Fund
Work Location: In person
📌 Insurance Executive (India)
🏢 Be Well Hospital puducherry
📍 India
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