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