Manage end-to-end health insurance claims, ensuring accuracy, compliance (ICD/CPT coding), and timely dispatch/settlement.
Liaison & Negotiation:
Act as the bridge between the hospital, insurance companies, and Third-Party Administrators (TPAs) to resolve issues, get approvals, and negotiate payments.
Team Leadership:
Recruit, train, supervise, and set performance targets for billing and insurance staff.
Process Improvement:
Develop and implement policies, analyze claim rejections/trends, and optimize processes for efficiency and reduced financial loss.
Compliance & Reporting:
Stay updated on regulations, ensure adherence, and provide regular reports on aging claims, rejections, and financial metrics to management.
Patient Support:
Address patient inquiries and complaints regarding coverage, claims status, and payments, ensuring high satisfaction.
Essential Skills & Qualifications
Education:
Bachelor's degree in Finance, Business, or related field.
Experience:
Proven experience in hospital billing, insurance operations, or TPA management.
Knowledge:
Strong understanding of medical billing, insurance policies, coding (ICD, CPT), and healthcare regulations.
Skills:
Leadership, problem-solving, communication, analytical skills, negotiation, and proficiency in MS Office/TPA software.
Job Type: Full-time
Pay: ₹50,000.00 - ₹60,000.00 per month
Work Location: In person
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