Pre-Authorization Management
Speaking with patients/attendants regarding pre-authorization for current admissions and addressing pre-auth queries, if any.
Ensuring that no pre-auth remains pending at the end of the day.
Insurance Tracker & Documentation
Updating the insurance tracker.
Updating settlement details in the insurance tracker.
Updating insurance settlement copies in a separate folder and informing the Accounts Department.
Update the insurance and billing tracker on a daily basis.
Claims Coordination
Addressing claim queries, coordinating with quick claims, and ensuring queries are replied to properly.
Ensuring that the final bill amount sent to the insurance matches the hospital bill.
Settlement & Refund Processing
Preparing recent Excel sheets for all pre-auth, final approval, and settlement details.
Processing refunds (after receiving the cancelled cheque, ensuring the refund documents reach the Accounts Department within 24 hours).
Handover & Communication
Updating the handover tracker and providing complete details of pending cases and approval cases to the PRO.
Training & Compliance
Attend all compulsory training related to the insurance process, HR, and administration.