Lead and manage the Medical Insurance Department of the hospital.
Build and maintain relationships with insurance companies, TPAs, and corporate clients.
Oversee pre-authorization approvals, claim submissions, and settlement follow-ups.
Monitor insurance policy coverage and eligibility for patients.
Coordinate between doctors, billing, accounts, and patients for insurance documentation.
Handle claim rejections and resolve disputes with insurers/TPAs.
Maintain MIS reports for daily, weekly, and monthly insurance activities.
Ensure timely closure of pending claims and revenue realization.
Develop SOPs and ensure compliance with IRDA and hospital standards.
Train, mentor, and guide the insurance team for effective performance.
Participate in audits and ensure proper documentation for all claims.
Provide management with insights on insurance trends and revenue impact.
Required Skills & Competencies:
Strong understanding of healthcare insurance processes and regulations.
Expertise in handling TPAs and corporate insurance tie-ups.
Strong leadership, negotiation, and conflict-resolution skills.
Excellent communication and interpersonal skills.
Knowledge of hospital billing and insurance software.
Analytical and detail-oriented mindset.
Qualifications & Experience:
Bachelor's / Master's degree in Business Administration, Hospital Administration, or related field.
8-15 years of experience in
medical insurance operations
(hospital or healthcare industry).
Prior experience in
leading an insurance/billing team
is preferred.
Job Types: Full-time, Permanent
Pay: ?20,000.00 - ?50,000.00 per month
Work Location: In person
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