Position Purpose

We are looking for an experienced and responsible Insurance Department Head / Supervisor to manage and monitor the complete insurance claim process, including Government and Private Insurance schemes, ECHS and other cashless/reimbursement claims.

Key Responsibilities

Supervise the day-to-day activities of the Insurance Department.

Ensure proper coordination between Insurance, Billing, Medical Records, Doctors, Nursing and Accounts Departments.

Monitor patient eligibility, pre-authorisation and approval processes.

Ensure timely preparation and submission of insurance claims.

Supervise ECHS, Government and Private Insurance claim processing.

Ensure proper document verification before submission of every claim.

Maintain scheme-wise and insurer-wise claim trackers.

Monitor pending, rejected, queried and settled claims and ensure timely follow-up.

Review claim discrepancies and coordinate with concerned departments for rectification.

Ensure proper documentation and record maintenance for audit purposes.

Monitor claim ageing and take corrective action for long-pending claims.

Prepare daily / weekly / monthly MIS reports for Management.

Ensure compliance with insurance company, Government scheme and hospital requirements.

Guide and train Insurance Department staff on proper claim procedures and documentation.

Establish and monitor appropriate SOPs, checklists and internal controls for the Insurance Department.

Coordinate with Accounts for claim settlement, reconciliation and outstanding follow-up.

Identify reasons for claim rejection/short settlement and implement corrective measures.





Ensure confidentiality and proper handling of patient and insurance-related documents.

Preferred Qualification & Experience

Graduate / Post Graduate in Hospital Administration, Healthcare Management, Finance, Commerce or related field.

Preferably 3–5 years of experience in hospital insurance / TPA / ECHS / Government scheme claim processing.

Strong knowledge of ECHS, CGHS, TPA and Private Insurance processes will be an advantage.

Positive communication, coordination and team-management skills.

Working knowledge of hospital billing and insurance software.

Ability to monitor claim status, analyse outstanding claims and prepare MIS reports.

Key Performance Areas (KPI)

Timely claim submission

Reduction in claim rejection rate

Reduction in pending/ageing claims

Timely response to insurance queries

Claim settlement and collection efficiency

Documentation accuracy

ECHS/TPA portal compliance

Proper maintenance of claim trackers and records

Team productivity and staff supervision

Coordination with Accounts and other hospital departments

Immediate Requirement

The position is required to be filled on priority basis to strengthen the Insurance Department's supervision, claim processing, documentation, follow-up and revenue recovery activities.

Interested and suitable candidates may share their updated CV with HR for further screening and interview.

Contact mob. No : +91-XXXXXXXXXX

Mail id : [email protected]

Pay: ₹30,000.00 - ₹60,000.00 per month

Benefits:

- Leave encashment
- Paid time off
- Provident Fund

Work Location: In person

📌 Insurance Department Head / Supervisor (India)
🏢 Ashwini Hospital
📍 India