Job Responsibilities
Handle CGHS and ESI insurance claims and related documentation.
Verify patient eligibility, insurance details, and required documents.
Coordinate with CGHS/ESI authorities for approvals, queries, and claim processing.
Prepare and submit claims accurately within the prescribed timelines.
Ensure proper documentation of bills, medical records, discharge summaries, and supporting documents.
Follow up on pending, rejected, and queried claims and take necessary corrective action.
Coordinate with billing, medical records, doctors, and other departments for claim-related requirements.
Maintain records of submitted, settled, pending, and rejected claims.
Ensure compliance with applicable CGHS and ESI guidelines and hospital procedures.
Assist in resolving patient and insurance-related queries.
Requirements
Bachelor's degree in any relevant discipline; healthcare/hospital administration preferred.
Minimum 6 months experience
Experience in CGHS and ESI insurance/claims processing preferred.
Good knowledge of hospital billing and insurance documentation.Valuable communication, coordination, and computer skills