- Bachelor’s Degree in Any Discipline (B.Com / BBA / B.Sc / BA) :
- Basic knowledge of hospital billing and insurance processes preferred
- Freshers can apply (training will be provided)
Experience
- 0-2 years of experience in hospital insurance / TPA process preferred
- Freshers with valuable communication skills may be considered
Job Summary
The Insurance Executive is responsible for handling insurance and TPA processes , coordinating with insurance companies, ensuring proper documentation, and facilitating cashless and reimbursement claims in accordance with hospital policies and **National Accreditation Board for Hospitals & Healthcare Providers standards.
- Coordinate with insurance companies and Third Party Administrators (TPA) for patient claims.
- Verify patient insurance eligibility and policy details .
2. Cashless Processing
- Initiate cashless authorization requests with insurance companies.
- Follow up with TPA/insurance providers for approval and queries .
3. Documentation
- Collect and verify all required documents for insurance claims .
- Maintain proper records of insurance approvals, claims, and patient files .
4. Billing Coordination
- Coordinate with billing department and doctors for treatment details.
- Ensure accurate documentation for insurance billing and claim submission .
5. Patient & Attender Communication
- Explain insurance procedures, approvals, and claim processes to patients and relatives.
- Provide guidance regarding cashless and reimbursement policies .
6. Claim Follow-up
- Track pending claims and follow up with insurance companies or TPAs .
- Ensure timely submission and settlement of claims .
7. Compliance
- Follow hospital policies and **National Accreditation Board for Hospitals & Healthcare Providers guidelines.
- Maintain confidentiality of patient information and insurance documents .
Key Skills
- Communication and coordination skills
- Basic computer knowledge (MS Office / Hospital Software)
- Documentation and record management
- Problem-solving ability
- Customer service skills
Working Conditions
- Regular hospital working hours
- Interaction with patients, insurance companies, and hospital departments
Additional Responsibilities
- Assist in insurance audits and reports .
- Support hospital billing and patient service departments when required.