The Insurance Executive is responsible for coordinating with insurance companies and Third-Party Administrators (TPAs) to ensure smooth processing of cashless and reimbursement claims. The role involves obtaining pre-authorizations, maintaining documentation, following up on approvals, and ensuring timely claim settlements while providing excellent support to patients.

Key Responsibilities:

- Process cashless and reimbursement insurance claims.
- Coordinate with TPAs and insurance companies for pre-authorizations and approvals.
- Verify patient insurance eligibility and policy coverage.
- Collect and maintain all required documents for claim processing.
- Follow up with insurance providers for pending approvals and claim settlements.
- Coordinate with doctors, nursing staff, billing, and medical records departments for required documents.
- Resolve insurance-related queries from patients and attendants.
- Ensure accurate documentation and compliance with hospital and insurance guidelines.
- Monitor rejected or pending claims and initiate corrective actions.




- Maintain daily MIS reports and insurance claim records.
- Support the billing team in insurance-related activities.
- Ensure timely closure of insurance cases and minimize claim rejections.

Required Skills:

- Knowledge of TPA and health insurance claim procedures.
- Familiarity with cashless and reimbursement processes.
- Good communication and interpersonal skills.
- Strong documentation and organizational abilities.
- Proficiency in MS Office (Excel, Word, Outlook).
- Ability to work under pressure and meet deadlines.
- Problem-solving and coordination skills.

Preferred Qualifications:

- Experience in hospital insurance desk operations.
- Knowledge of major TPAs and insurance companies.
- Experience with Hospital Information Systems (HIS) is an advantage.

Key Competencies:

- Attention to Detail
- Customer Service Orientation
- Teamwork
- Time Management

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

Advantages:

- Provident Fund

Work Location: In person

📌 insurance coordinator at hospital (India)
🏢 KKR ENT HOSPITAL & RESEARCH INSTITUTE
📍 India