About the role:

The Senior Mediclaim Executive – Administration will lead end-to-end cashless and reimbursement mediclaim operations. Reporting directly to the Head of Administration / Billing Manager, the role holder will serve as the bridge between patients/employees, hospital administration, insurance companies, and Third-Party Administrators (TPAs). This position directly drives organizational success by expediting claim settlements, minimizing claim rejections, and enhancing the overall patient experience.

Responsibilities:

· Oversee the end-to-end mediclaim pre-authorization, admission, query resolution, and final claim settlement workflows.

· Liaise directly with TPAs, insurance companies, hospital billing units, and treating doctors to secure timely cashless approvals and documentations.

· Audit and verify all medical records, discharge summaries, billings,



and investigation reports to prevent claim discrepancies and rejection risks.

· Handle escalated claim disputes, claim deductions, and grievances from patients, providing transparent guidance and swift resolution.

· Manage reconciliation of settled claims with the finance department and monitor accounts receivable aging reports for pending insurance payouts.

· Guide junior executives on IRDAI / regulatory compliance, internal standard operating procedures (SOPs), and healthcare protocol changes.

· Maintain comprehensive claim tracking records and generate monthly operational reports highlighting settlement ratios, pending claim volumes, and turnaround times (TAT).

Pay: ₹20,000.00 - ₹45,000.00 per month

Work Location: In person

📌 Senior Mediclaim Executive – Administration (Beleghata)
🏢 Divine Multispeciality Hospital
📍 Beleghata