We are looking for a Hospital Insurance Executive to manage insurance and TPA-related activities, including patient insurance verification, pre-authorisation, claim processing, discharge approval, documentation, and claim follow-up.
Roles & Responsibilities
- Verify patient insurance eligibility and policy details.
- Handle insurance and TPA pre-authorisation requests.
- Coordinate with doctors and hospital departments for required medical documents.
- Follow up with insurance companies/TPAs for approval and queries.
- Coordinate insurance patients during admission and discharge.
- Prepare and submit complete insurance claim documents.
- Track pending, approved, rejected and settled claims.
- Follow up on outstanding insurance payments.
- Identify and resolve claim deductions, rejections and documentation issues.
- Coordinate with Billing, Accounts, Nursing, Pharmacy, Laboratory and other departments.
- Maintain daily insurance/TPA records and MIS reports.
- Handle patient/attendant queries related to insurance claims.
- Ensure all insurance documentation is accurate, complete and submitted within the required timeline.
- Maintain confidentiality of patient and insurance information.