Role & responsibilities:

- Manage the hospital insurance desk and assist patients with cashless and reimbursement insurance processes.
- Verify patient insurance eligibility, policy coverage, and pre-authorization requirements.
- Coordinate with insurance companies, TPAs, and insurance brokers for cashless approvals.
- Prepare and submit pre-authorization requests along with the required medical documents within stipulated timelines.
- Follow up regularly with insurers/TPAs to obtain timely approvals and resolve queries.
- Coordinate with treating doctors, nursing staff, billing department, medical records, and pharmacy for accurate documentation.
- Ensure all claim documents are complete, accurate, and submitted as per insurer/TPA guidelines.
- Facilitate admission, enhancement requests, discharge approvals, and final claim settlements.
- Educate patients and their attendants on policy coverage, exclusions, co-payments, deductibles, and claim procedures.
- Resolve insurance-related patient queries and provide a high level of customer service.
- Maintain proper records of all insurance cases, approvals, denials, pending claims, and claim status.




- Coordinate with the hospital billing department to ensure timely billing and claim submission.
- Track pending claims and follow up for settlement to minimize outstanding receivables.
- Ensure compliance with hospital policies, insurer guidelines, IRDAI regulations, and internal SOPs.
- Build and maintain skilled relationships with insurance companies, TPAs, and hospital departments.
- Assist in achieving departmental turnaround time (TAT) and quality benchmarks.

Preferred candidate profile:

- Graduate in any discipline (Healthcare Administration, Nursing, Pharmacy, Life Sciences, or Commerce preferred).
- 2 to 8 years of experience in a hospital insurance desk, TPA, insurance company, or healthcare claims environment.
- Knowledge of cashless hospitalization, reimbursement claims, medical insurance documentation, and claim processing.
- Good communication, interpersonal, and customer handling skills.
- Proficiency in MS Office and Hospital Information Systems (HIS).
- Ability to work in rotational shifts if required.
- Strong attention to detail and documentation skills.

📌 Insurance Officer (Thiruvananthapuram)
🏢 Wellvoyage Healthcare Solutions
📍 Thiruvananthapuram