Key Responsibilities

1. Insurance & TPA Coordination

- Coordinate with TPAs (Third Party Administrators) and insurance companies for claim processing.
- Handle cashless approvals, pre-authorizations, and claim submissions.
- Follow up for approvals, queries, and claim settlements.

2. CGHS Process Management

- Manage CGHS patient documentation, eligibility verification, and approval process.
- Ensure compliance with CGHS guidelines and package rates.
- Prepare and submit CGHS bills and supporting documents.

3. Billing & Documentation

- Prepare accurate insurance and CGHS bills as per hospital policies.
- Maintain proper documentation for claims, approvals, and rejections.
- Handle discrepancies and resubmissions.

4. Patient Coordination

- Guide patients and attendants regarding insurance and CGHS procedures.
- Explain billing, approvals, and required documents clearly.





5. Claims Follow-up & Reconciliation

- Track pending claims and ensure timely settlement.
- Reconcile payments received from insurance/CGHS.
- Maintain reports on pending, approved, and rejected claims.

6. Compliance & Audit

- Ensure adherence to hospital policies, insurance norms, and CGHS regulations.
- Support internal and external audits.
- Maintain confidentiality of patient and financial data.

Qualifications & Experience

- Graduate in any discipline (commerce/healthcare management preferred).
- 2-4 years of experience in hospital insurance/TPA/CGHS processing preferred.
- Knowledge of medical billing and insurance procedures.

📌 Walkin - Insurance CGHS Process -(2-3 years Hospital Experience) (Chennai)
🏢 Dr.Kamakshi Memorial Hospital
📍 Chennai