Handle pre-authorization requests for patients, verify insurance documents, and secure timely cashless approvals from insurance companies and TPAs.
Prepare, review, and submit accurate medical bills, discharge summaries, and claim documents to insurance providers within set deadlines.
Guide patients and their families through the insurance process, explaining cashless procedures, coverage limits, and required documentation.
Upload patient medical files onto online TPA portals and courier hard copies of documents to insurance offices.
Track pending and outstanding claims daily, coordinate with insurance adjusters, and resolve queries or billing discrepancies to explicit payments.
Coordinate with the hospital's finance and accounts departments to reconcile payments, track receivables, and prepare daily or monthly MIS reports.
Ensure all processes adhere to hospital policies, insurance guidelines, and regulatory requirements during internal and external audits.