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 Managem

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