Job Description

Department: Insurance

Job Summary:

The Insurance Coordinator is responsible for managing all aspects of patient insurance processes, including verification, preauthorization, documentation, claims submission, and follow-up. The role ensures smooth coordination between patients, insurance companies, and hospital departments to facilitate timely and accurate claim settlements.

Key Responsibilities:

Insurance Verification & Preauthorization:

Verify patients insurance coverage, eligibility, and policy details before admission or treatment. Obtain preauthorization from insurance providers for procedures, surgeries, and inpatient admissions.

Documentation & Coordination:

Ensure all required patient and clinical documents are complete and accurately submitted to the insurer. Liaise with consultants, doctors, and billing departments for clarification and supporting documents.

Claims Management:

Prepare and submit insurance claims within the specified timelines. Track claim status and follow up with insurance companies to resolve pending or denied claims.

Patient Communication:

Explain insurance processes, coverage limits, and exclusions to patients and their families. Assist patients with queries regarding insurance approvals and claim settlements.

Compliance & Reporting:

Maintain accurate records of insurance correspondence and claim logs. Ensure compliance with hospital policies, TPA (Third-Party Administrator), and regulatory requirements. Generate daily, weekly, and monthly insurance reports for management review.

Qualifications & Skills:

Bachelors degree in Hospital Administration, Commerce, or related field. 1 to 3 years of experience in hospital insurance or billing department preferred. Good knowledge of health insurance procedures, TPAs, and claim documentation. Strong communication and coordination skills.
Job Type: Full-time

Pay: ₹8,848.49 - ₹350,000.00 per month

Benefits:

Flexible schedule Leave encashment Paid time off
Work Location: In person