- Bachelor's degree.
- Minimum 3+ years of hospital experience in insurance/TPA claims preferred.
- Experience in hospital insurance/TPA claims preferred.
- Valuable communication and computer skills.
- Knowledge of health insurance claim processing.
- Ability to independently handle complex insurance claims and coordinate with TPAs and insurance companies.
Description:
- Handle cashless and reimbursement insurance claims.
- Coordinate with insurance companies and TPAs.
- Verify patient insurance eligibility and documentation.
- Follow up on claim approvals and settlements.
- Maintain accurate insurance records and reports.
- Monitor and guide the insurance team to ensure timely and accurate claim processing.
- Handle complex claim issues, rejections, and escalations and coordinate with TPAs/insurance companies for resolution.
- Prepare and review insurance-related MIS reports and ensure timely submission and closure of pending claims.