Carmel Medical Centre is looking for an Insurance Executive / Insurance Coordinator to manage hospital insurance and TPA-related activities and ensure smooth processing of patient insurance claims.
Key Responsibilities
- Handle day-to-day hospital insurance and TPA coordination.
- Verify patient insurance eligibility, policy details and required documents.
- Coordinate with insurance companies and TPAs for pre-authorisation and claim approvals.
- Prepare and submit insurance claim documents accurately and on time.
- Coordinate with doctors, billing, nursing, medical records and other departments for required documentation.
- Follow up on pending approvals, queries, rejected claims and settlements.
- Review bills, discharge summaries and supporting medical documents before claim submission.
- Communicate with patients and attendants regarding insurance procedures and requirements.
- Maintain proper records of submitted, approved, pending and rejected claims.
- Respond to queries raised by insurance companies/TPAs and provide required documents.
- Ensure confidentiality of patient and insurance-related information.
- Prepare regular reports related to insurance claims and settlements.
Requirements
- Minimum 1 year of experience in hospital insurance/TPA/claims processing preferred.
- Experience in a hospital insurance department will be an added advantage.
- Positive knowledge of hospital billing and insurance documentation.
- Knowledge of cashless and reimbursement claims.
- Good communication and coordination skills.
- Basic computer and MS Office/Excel knowledge.
- Ability to work independently and coordinate with multiple departments.
- Candidates with relevant hospital insurance experience are preferred.