We are seeking an experienced Head of Insurance Operations to lead and oversee insurance-related operations across a hospital group operating in Andhra Pradesh and Telangana. The ideal candidate should have 10+ years of relevant experience in hospital insurance operations, with strong knowledge of health insurance processes, Third-Party Administrator (TPA) coordination, claims management, and cashless services. The role requires effective leadership to improve operational efficiency, ensure timely claim processing, and maintain strong relationships with insurance partners.

Qualifications

- Bachelor's degree in Healthcare Management, Hospital Administration, Business Administration, or a related field. A postgraduate qualification is preferred.

- 10+ years of relevant experience in hospital insurance operations.

- Proven experience in handling insurance and TPA operations across multiple hospital units.

- Strong knowledge of cashless authorization, pre-authorization, claim submission, settlement, and reimbursement processes.

- Understanding of health insurance policies, billing procedures, and applicable regulatory requirements.

- Experience managing insurance teams and coordinating with hospital departments.

- Strong negotiation, communication, analytical, and problem-solving skills.

- Ability to manage multiple locations and coordinate with senior management.

Responsibilities





- Lead and oversee insurance operations across all hospital branches in Andhra Pradesh and Telangana.

- Manage end-to-end insurance and TPA processes, including pre-authorization, cashless approvals, claim submission, and settlement.

- Ensure timely and accurate processing of insurance claims and documentation.

- Coordinate with insurance companies and TPAs to resolve claim queries, deductions, and rejections.

- Monitor pending claims, outstanding amounts, settlement timelines, and revenue performance.

- Develop and implement standard operating procedures for insurance operations across all branches.

- Guide, train, and monitor insurance department teams to maintain consistent service standards.

- Coordinate with billing, medical records, finance, front office, and clinical departments.

- Review claim rejection trends and implement measures to reduce errors and revenue leakage.

- Maintain effective working relationships with insurance providers and corporate clients.

- Prepare regular reports on insurance performance, claim status, collections, and operational issues.

- Ensure compliance with hospital policies, insurance guidelines, and applicable regulatory requirements.

Pay: ₹60,000.00 - ₹80,000.00 per month

Perks

- Leave encashment

- Paid sick time

- Provident Fund

Work Location: In person

📌 Head of Insurance Operations (Piduguralla)
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📍 Piduguralla