1. Job Summary

The Insurance Executive is responsible for handling inpatient insurance claims, pre-authorization, claim documentation, submission, and settlement follow-up for private health insurance companies, TPAs, and government health insurance schemes. The role ensures accurate documentation, timely claim processing, and compliance with hospital and insurance requirements.

2. Key Responsibilities

- Handle cashless insurance processes for inpatient admissions and discharges.
- Coordinate with private insurance companies, TPAs, and government health insurance scheme authorities.
- Verify patient insurance eligibility, policy details, coverage, and required documents.
- Prepare and submit pre-authorization requests, enhancement requests, and final claims within the prescribed timelines.
- Ensure accurate and complete documentation, including medical records, investigation reports, discharge summaries, bills, and other supporting documents.
- Process claims under applicable government schemes such as CMCHIS and other empanelled schemes, as applicable.
- Follow up on pending approvals, claim queries, deductions, rejections, and settlement status.
- Coordinate with doctors, nursing staff, medical records, billing, and other departments to collect the required documents.
- Identify documentation gaps and ensure timely correction to minimize claim rejections and delays.
- Maintain insurance claim registers, trackers, and records of approvals, submissions, settlements,



and outstanding claims.
- Assist in resolving insurance-related patient queries and provide updates regarding approval and discharge procedures.
- Support insurance audits and ensure compliance with insurer, TPA, government scheme, and hospital requirements.
- Prepare periodic reports on claims submitted, approved, rejected, pending, and settled.

3. Qualification

- Any degree; candidates with a degree or diploma in Healthcare Management, Hospital Administration, or a related field are preferred.

4. Experience

- 1–3 years of experience in hospital insurance, billing, or claim processing is preferred.
- Experience handling private insurance, TPA claims, and government health insurance schemes will be an advantage.
- Freshers with relevant knowledge may also be considered.

5. Required Skills

- Knowledge of hospital billing, insurance claims, and medical documentation.
- Familiarity with cashless authorization and government insurance scheme procedures.
- Good communication, coordination, and follow-up skills.
- Basic computer knowledge and proficiency in MS Office and hospital information systems.
- Robust attention to detail and documentation accuracy.
- Ability to work under pressure and meet claim submission deadlines.

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

Benefits:

- Flexible schedule
- Paid time off
- Provident Fund

Work Location: In person

📌 Insurance Executive (Madurai)
🏢 Preethi Hospitals
📍 Madurai