Key Responsibilities:
- Handle insurance verification, pre-authorization, and approval processes for patients.:
- Coordinate with TPAs and insurance companies for cashless and reimbursement claims.
- Prepare, review, and submit insurance documents and bills accurately.
- Monitor claim status and follow up for timely settlements.
- Ensure compliance with insurance policies, hospital protocols, and regulatory requirements.
- Resolve insurance queries and support patients regarding coverage and claim procedures.
- Maintain proper records of insurance cases and billing documentation.
- Coordinate with billing, medical records, and clinical departments.
- Prepare periodic reports on claims, rejections, and pending cases.
- Train front office/billing staff on insurance procedures when required.
Qualifications & Skills:
- Graduate in any discipline (Healthcare Administration preferred).
- Experience in hospital insurance/TPA handling preferred.
- Knowledge of medical billing and insurance processes.
- Good communication, documentation, and coordination skills.
- Basic computer and hospital information system knowledge.