Job Title: Insurance Executive

Department: Insurance / TPA Desk

Location: Krishnagiri l

Reports To: Finance Manager / Billing Manager

Job Summary

The Insurance Executive is responsible for managing all hospital insurance processes including patient eligibility verification, pre-authorization, claim processing, and coordination with insurance companies/TPAs. The role ensures timely approvals, accurate documentation, and smooth claim settlement while maintaining patient satisfaction.

Key Responsibilities1. Insurance & TPA Coordination

- Coordinate with insurance companies and TPAs for cashless approvals and claim processing
- Handle pre-authorization requests and ensure timely approvals
- Follow up on pending claims, queries, and settlements

2. Patient Insurance Handling

- Verify patient insurance eligibility and policy coverage before admission
- Explain insurance procedures, coverage, exclusions, and required documents to patients
- Address patient and attendant queries regarding insurance claims

3. Documentation & Claim Processing

- Collect, verify, and submit all required documents for claims
- Ensure accurate coding, billing, and documentation for claim approval
- Maintain proper records of approvals, rejections, and settlements

4. Interdepartmental Coordination

- Coordinate with doctors, nursing staff, billing, and MRD for claim-related documents
- Work closely with billing department to resolve discrepancies




- Ensure smooth discharge process with insurance clearance

5. Follow-up & Reporting

- Track pending claims and ensure timely closure
- Prepare daily, weekly, and monthly MIS reports
- Monitor Accounts Receivable (AR) related to insurance cases

6. Compliance & Audit

- Ensure compliance with hospital policies and insurance guidelines
- Support internal and external audits
- Maintain confidentiality of patient and insurance data

Qualifications

- Bachelor’s Degree (B.Com / BBA / Any Graduate)
- Preferred: Hospital Administration / Healthcare Management

Experience

- 1–3 years (Freshers with knowledge can be considered)
- Experience in hospital insurance / TPA / billing preferred

Key Skills

- Knowledge of health insurance & TPA processes
- Positive communication and patient handling skills
- Strong documentation & coordination skills
- Computer knowledge (MS Office & HIS)
- Problem-solving and follow-up skills

Key Performance Indicators (KPIs)

- Timely pre-authorization approvals
- Claim submission accuracy
- Reduction in claim rejections
- Faster claim settlement turnaround time
- Patient satisfaction

Salary Range (Indicative)

- ₹10,000 – ₹15,000/month (based on experience)

Pay: ₹10,000.00 - ₹15,000.00 per month

Benefits:

- Cell phone reimbursement
- Paid time off
- Provident Fund

Work Location: In person

📌 Insurance Executive (India)
🏢 Umarani Multispeciality! Hospital
📍 India