Job Description

Key Responsibilities:

Claim Management

: Manage the full cycle of health insurance claims, ensuring accuracy, compliance, and timely submission and resolution, minimizing rejections.

ABRK & Yashaswini Scheme

Team Leadership

: supervise, and evaluate staff processing claims, setting performance standards and ensuring targets are met.

Liaison & Negotiation

: Act as the main point of contact with insurance companies, Third-Party Administrators (TPAs), and corporate clients to resolve issues, negotiate terms, and ensure payments.

Policy & Compliance

: Stay updated on healthcare policies, regulations, and insurance schemes, ensuring hospital systems and procedures adhere to current standards.

Reporting

: Prepare and present regular reports on claim status, aging, rejections, and financial performance to management.

Patient Support

: Handle inquiries and complaints from patients regarding their insurance claims and coverage.
Essential Skills & Qualifications:

Experience

: Proven experience in health insurance, claims processing, or a related healthcare administration role.

Knowledge

: Strong understanding of health insurance operations, medical terminology, and regulations.

Leadership

: Excellent team management, delegation, and performance coaching skills.

Analytical Skills

: Ability to interpret data, identify trends, and solve complex problems.

Communication

: Strong written and verbal communication for interacting with patients, staff, and insurers.

Education

: Often requires a degree in Health Administration, Business, or a related field.
Pay: From ?40,000.00 per month

Work Location: In person