Job Title

Health Insurance Executive / Insurance Coordinator

Department

Insurance / Billing / Administration

Job Summary The Health Insurance Executive is responsible for coordinating insurance-related activities for patients, including insurance verification, pre-authorization, claim processing, documentation, follow-up, and coordination with insurance companies and Third-Party Administrators (TPAs).

Key Responsibilities

- Verify patient insurance eligibility and policy details.
- Explain insurance procedures, coverage, exclusions, and required documents to patients and their attendants.
- Coordinate cashless admission and treatment procedures with insurance companies/TPAs.
- Prepare and submit pre-authorization requests with accurate medical and patient details.
- Coordinate with doctors, nursing staff, billing, medical records, and administration for required documents.
- Follow up on pre-authorization approvals and queries from insurance companies/TPAs.
- Prepare and submit insurance claims within the required timelines.
- Ensure claim documents are complete, accurate, and properly arranged.
- Track pending, approved, rejected, and settled claims.
- Follow up on claim rejections, deductions, queries, and resubmissions.
- Maintain proper records of all insurance patients and claims.
- Coordinate discharge authorization and final bill submission.
- Communicate professionally with insurance companies, TPAs, patients, and hospital departments.
- Maintain confidentiality of patient and insurance-related information.




- Prepare daily/weekly/monthly insurance reports for management.
- Ensure compliance with hospital policies and applicable insurance procedures.
- Perform any other insurance-related duties assigned by management.

Required Skills
- Good communication and interpersonal skills.
- Basic knowledge of health insurance and TPA procedures.
- Knowledge of cashless hospitalization and claim processing.
- Good computer skills, especially MS Word and Excel.
- Strong documentation and follow-up skills.
- Ability to coordinate with multiple departments.
- Good attention to detail.
- Ability to work under pressure and meet deadlines.

Educational Qualification Minimum: Any Degree / Diploma

Preferred: Experience in hospital insurance, billing, TPA coordination, or healthcare administration.

Experience

Preferred: 1–3 years of experience in hospital insurance/TPA coordination or medical billing.

Working Relationship

Reports To: Hospital Administration / HR / Accounts Manager

Coordinates With:

Doctors Nursing Department Billing Medical Records Pharmacy Administration Insurance Companies TPAs

Performance Indicators

- Timely submission of pre-authorization requests.
- Timely claim submission and processing.
- Reduction in claim rejection and documentation errors.
- Effective follow-up of pending claims.
- Accurate maintenance of insurance records.
- Patient satisfaction and effective coordination.

Pay: ₹15,000.00 - ₹25,000.00 per month

Benefits

- Cell phone reimbursement
- Versatile schedule
- Food provided
- Leave encashment

Work Location: In person

📌 Insurance Advisor (Tiruchirappalli)
🏢 SIDDHAR VANAM SIDDHA HOSPITAL
📍 Tiruchirappalli