Key Responsibilities

- Insurance & TPA Coordination

- Coordinate with insurance companies and TPAs for cashless hospitalisation.
- Verify patient insurance eligibility and policy details.
- Explain the basic insurance process, requirements and documentation to patients and bystanders.
- Coordinate pre-authorisation requests with the concerned insurance company/TPA.
- Ensure timely submission of required documents and medical information.
- Follow up on pending approvals and queries.

2. Admission & Pre-Authorization
- Collect and verify insurance cards, ID proof, policy details and other required documents.
- Prepare and submit pre-authorisation forms accurately.
- Coordinate with doctors and clinical departments for required medical reports, diagnosis, treatment plans and estimates.
- Follow up with the TPA/insurance company until approval is received.
- Maintain proper records of all authorisation requests and approvals.

3. During Hospitalization
- Monitor the insurance status of admitted patients.
- Coordinate with billing and clinical departments regarding treatment estimates and insurance limits.
- Submit additional authorization requests whenever there is a change in treatment or estimated cost.
- Respond promptly to queries raised by insurance companies/TPAs.
- Keep patients and concerned departments informed about approval status and limitations.

4. Discharge & Final Authorization
- Coordinate with the billing department for preparation of the final bill.
- Submit discharge summaries,



final bills and other required documents to the TPA/insurance company.
- Obtain final authorization/settlement approval before discharge, wherever applicable.
- Coordinate settlement of deductions, non-payable items and co-payment amounts.
- Explain insurance deductions and patient payable amounts clearly and politely.

5. Claims & Documentation
- Prepare and submit complete claim documents within the required timelines.
- Ensure all documents are accurate, complete and properly signed/stamped.
- Track pending claims and follow up regularly with TPAs/insurance companies.
- Maintain records of submitted, approved, rejected and pending claims.
- Coordinate with the accounts/finance department regarding claim settlements and outstanding amounts.
- Identify missing documents or discrepancies and arrange timely corrections.

6. Coordination with Hospital Departments
- Coordinate effectively with:
- Doctors
- Nursing Department
- Front Office
- Billing Department
- Medical Records Department
- Pharmacy
- Laboratory
- Radiology
- Accounts/Finance
- Ensure timely collection of documents required for insurance processing.
- Communicate insurance-related requirements to concerned departments.

Required Qualifications
- Minimum 2–5 years of experience in hospital insurance/TPA coordination preferred.
- Experience in cashless hospitalisation and insurance claim processing is preferred.
- Knowledge of major health insurance/TPA procedures will be an advantage.

Pay: ₹10,000.00 - ₹40,000.00 per month

Work Location: In person

📌 Insurance Coordinator (Perintalmanna)
🏢 ASCENT ENT HOSPITALu0026 MEDICAL CENTRE
📍 Perintalmanna