Position

Insurance Coordinator

Department

Insurance / Billing

Reports To - HR Manager

Job Summary

The Insurance Coordinator is responsible for managing all insurance-related activities, including cashless authorization, pre-authorization, claim documentation, coordination with insurance companies/TPAs, patient counseling regarding insurance coverage, and ensuring timely claim submission and settlement while complying with hospital policies and insurer guidelines.

Key ResponsibilitiesInsurance & TPA Coordination
- Coordinate with insurance companies and TPAs for cashless treatment approvals.
- Submit pre-authorization requests with complete supporting documents.
- Follow up on pending approvals and communicate status to patients and clinicians.
- Ensure timely claim submission and reimbursement processing.

Documentation
- Verify patient insurance eligibility and policy coverage.
- Collect and maintain all required documents, including ID proofs, insurance cards, medical records, investigation reports, and discharge summaries.
- Ensure documentation is complete, accurate,



and compliant with insurer requirements.
- Maintain confidential patient records.

Billing & Claims
- Coordinate with the billing department to prepare accurate final bills.
- Reconcile approved amounts with hospital billing.
- Track claim status and resolve claim rejections, deductions, and queries.
- Maintain records of submitted, approved, pending, and rejected claims.

Patient Coordination
- Explain insurance processes, coverage, exclusions, and patient liabilities.
- Assist patients in completing insurance-related forms.
- Address patient queries regarding cashless and reimbursement claims.

Coordination with Internal Departments
- Work closely with doctors, nursing staff, medical records, billing, and front office.
- Ensure all required clinical documents are obtained on time for claim processing.

Reporting
- Prepare daily and monthly reports on insurance cases.
- Monitor turnaround ti

📌 Insurance Coordinator (Chromepet)
🏢 RK Speciality Hospital
📍 Chromepet