Job Description

Job Summary

The Insurance Officer cum Billing Executive is responsible for handling all inpatient/outpatient insurance operations, coordinating with TPAs/insurance companies, preparing accurate bills, managing approvals, and ensuring smooth discharge and claim processing.

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Key Responsibilities

1. Insurance Operations

Verify insurance eligibility and coverage for all patients. Collect necessary documents from patients for insurance processing. Submit pre-authorization (pre-auth) requests and follow up with TPAs/insurance companies. Monitor approval status, enhancements, and queries. Explain insurance terms, co-payments, and non-payable items to patients/attenders. Assist doctors and departments to complete required supporting documents.
2. Billing Responsibilities

Prepare interim and final bills for inpatient (IP) and outpatient (OP) services. Ensure accurate posting of all charges: room, pharmacy, lab, radiology, procedures, doctor visits, consumables, etc. Check for missing charges and coordinate with departments before final billing. Prepare separate insurance bills and patient-payable bills according to TPA guidelines. Coordinate with discharge team to ensure smooth and timely patient discharge.
3. Cash Handling (if applicable)

Collect co-payments, non-payable items, and any balance amounts from patients. Issue receipts and maintain accurate transaction records. Hand over daily cash collection to accounts/finance.
4. TPA / Insurance Coordination

Maintain regular communication with TPAs and insurance officials. Submit required documents for final authorization. Resolve queries and respond to TPA clarifications promptly. Ensure timely submission of insurance claims for reimbursement. Track claim status and follow up on pending or rejected claims.
5. Documentation & Compliance

Maintain complete insurance files--pre-auth, approvals, bills, claim forms, discharge summaries, invoices. Ensure all documentation is as per insurance guidelines. Support internal/external audit processes. Maintain confidentiality of patient and financial information.
Skills & Competencies

Strong knowledge of hospital insurance & billing processes Familiar with TPA guidelines and claim workflows Good communication & negotiation skills Ability to handle pressure during discharge hours Basic accounting and billing knowledge Proficient in HIS/billing software and MS Office
Qualification & Experience

Education: B.Com, BBA, Diploma in Hospital Administration, or similar Experience: 1-4 years in hospital insurance desk or billing Technical: Hands-on experience with hospital billing software
Location : No-18, Ramachandra Iyer Street, Nehru Nagar, Chromepet, Chennai, Tamil Nadu, 600044

Call or Whatsapp : 9-7-3-1-6-1-3-3-6-2

Job Type: Permanent

Pay: ₹20,000.00 - ₹25,000.00 per month

Benefits:

Paid time off Provident Fund
Education:

Diploma (Required)
Work Location: In person