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:- +91-XXXXXXXXXX

Pay: ₹15,000.00 - ₹25,000.00 per month

Work Location: On the road

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