Job Description

Job Title:

Mediclaim Executive

Department:

Billing & Insurance

Location:

[Sahaj Hospital]

:

The Mediclaim Executive is responsible for handling all activities related to medical insurance claims, including documentation, claim processing, coordination with TPAs (Third Party Administrators), insurance companies, and patients to ensure timely and accurate reimbursement.

Key Responsibilities:

Process and submit Mediclaim documentation for cashless and reimbursement claims. Coordinate with patients, TPAs, and insurance companies regarding claim approvals and queries. Ensure timely follow-up for pending or rejected claims and rectify issues as needed. Maintain accurate records of all insurance claims, pre-authorizations, and approvals. Explain Mediclaim procedures and required documentation to patients and their families. Liaise with the billing department to ensure correct billing codes and claim submissions. Prepare and submit regular reports related to insurance claim status and revenue.

Key Skills & Qualifications:

Graduate in any discipline (preferably commerce or healthcare-related). 1-3 years of experience in Mediclaim or TPA handling (preferred). Strong knowledge of medical terminology, hospital billing, and insurance claim processes. Good communication and coordination skills. Proficiency in MS Office and hospital management systems.
Job Type: Full-time

Schedule:

Day shift
Work Location: In person