Nadakkavil Hospital is looking for an experienced Insurance Coordinator / Insurance Manager to manage health insurance operations, coordinate with insurance companies and TPAs, and ensure smooth cashless and reimbursement claim processing for patients.
Candidates must have previous experience in hospital insurance coordination, TPA operations or health insurance management.
Key Responsibilities
- Coordinate cashless hospitalization procedures with insurance companies and TPAs.
- Process and follow up on pre-authorisation requests.
- Obtain insurance approvals for admissions, treatments and procedures.
- Coordinate discharge approvals and final claim submissions.
- Verify insurance eligibility, policy coverage and patient documents.
- Ensure accurate and timely submission of insurance claims.
- Follow up on pending approvals, queries, deductions and rejected claims.
- Coordinate with billing, medical records, doctors and nursing departments.
- Explain insurance procedures and coverage-related queries to patients and attendants.
- Monitor claim status and maintain insurance-related records.
- Identify claim discrepancies and take necessary corrective action.
- Maintain communication with insurance companies, TPAs and corporate clients.
- Prepare daily and monthly insurance reports.
- Ensure compliance with hospital policies and insurance procedures.
Educational Qualification
- Any Degree preferred.
- B.Com / BBA / MBA / Hospital Administration preferred.
- Knowledge of health insurance and TPA procedures is essential.
Experience Requirements
- 2–5 years of previous hospital or health insurance experience is mandatory.
- Experience as an Insurance Coordinator, Insurance Executive or Insurance Manager preferred.
- Practical knowledge of cashless hospitalization and claim processing is required.
Skills Required
- Good knowledge of health insurance and TPA operations.
- Strong communication and negotiation skills.
- Knowledge of cashless and reimbursement procedures.
- Good documentation and computer skills.
- Problem-solving and follow-up skills.
- Ability to coordinate with multiple departments.
- Attention to detail and accuracy.