To coordinate all insurance and TPA-related activities, ensuring timely pre-authorization, claim processing, documentation, billing, and settlement while providing excellent support to patients and insurance companies.
Job Responsibilities
Handle insurance and TPA claim processes.
Obtain pre-authorization approvals for cashless patients.
Verify insurance documents and patient eligibility.
Coordinate with insurance companies, TPAs, doctors, and billing department.
Prepare and submit claim documents accurately and on time.
Follow up on pending approvals, claims, and settlements.
Resolve claim queries and maintain proper records.
Guide patients regarding insurance procedures.
Requirements
Any Bachelor's Degree.
1–3 years of experience in hospital insurance/TPA claim processing preferred.
Good communication and coordination skills.
Basic computer knowledge (MS Office/Hospital Software).
Ability to work independently and maintain accurate documentation.
Skills
Positive communication and interpersonal skills.
Knowledge of insurance and TPA procedures.
Robust documentation and record-keeping skills.
Basic medical terminology knowledge.
Computer proficiency (MS Office and Hospital Information System).
Time management and multitasking abilities.
Problem-solving and negotiation skills.
Salary: Salary will be commensurate with the candidate's qualifications and relevant experience.
Working Hours
As per hospital duty roster.
May be required to work on weekends, holidays, or extended hours based on patient admissions and discharge requirements.