Hospital Insurance Executive

Department: Insurance / Billing / TPA

Experience: 1–5 Years

Location: Hospital

Employment Type: Full time

Job Summary

We are looking for a responsible and detail-oriented Hospital Insurance Executive to manage insurance and TPA-related activities, including patient documentation, pre-authorisation, claim processing, coordination with insurance companies/TPAs, and settlement follow-up.

Key Responsibilities

- Handle cashless insurance and TPA patients from admission to discharge.
- Verify patient insurance details, eligibility, policy coverage, and required documents.
- Coordinate with Insurance Companies, TPAs, Doctors, Billing, Medical Records, and Nursing Departments.
- Prepare and submit pre-authorisation requests with accurate medical and patient details.
- Follow up on approval, enhancement, and final authorisation requests.
- Ensure timely submission of discharge summaries, bills, investigation reports, prescriptions, and other required documents.




- Coordinate with the billing team for final bill preparation and claim submission.
- Monitor pending approvals, claims, queries, and settlements.
- Respond to insurance/TPA queries and provide the required clarifications and documents.
- Maintain proper records of insurance claims and patient-related documents.
- Follow up on outstanding claims and rejected/denied claims.
- Ensure compliance with hospital policies and insurance/TPA requirements.
- Maintain confidentiality and accuracy of patient and insurance information.
- Prepare daily/weekly/monthly reports related to insurance and TPA claims.

Qualification

- Any Degree / Diploma.

Experience

- 1–5 years of experience in Hospital Insurance / TPA / Billing / Claims Department.
- Freshers with relevant healthcare/insurance knowledge may also be considered for junior positions.

Contact:- (phone hidden) Pay: ₹15,000.00 - ₹25,000.00 per month

Work Location: On the road

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