Key Responsibilities
Collect, verify and maintain insurance documentation (policies, cards, authorizations, endorsements)
Assist with pre-authorization or approval requests with insurance companies / TPAs
Prepare, submit and follow up on insurance claims (cashless and reimbursement)
Track status of pending claims, rejections, and denials and resolve issues
Verify coverage, eligibility, co-payments, deductibles etc., and explain these to clients/patients
Coordinate with internal departments (billing, admissions, medical / service teams) to get required information for claims
Maintain accurate and up-to-date records of all insurance activities, communications & claim status
Generate reports on metrics like claim acceptance rate, turnaround time, rejections etc.
Handle queries from patients / clients / insurance companies regarding insurance or claims
Ensure compliance with insurance policies, regulations, and company procedures
Follow up on policy renewals, changes, terminations, endorsements etc.
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