Job Description

Job Summary:

The

Pre-Authorization Executive

is responsible for handling insurance-related processes for patients admitted under health insurance coverage. The role involves coordinating with doctors, patients, and Third-Party Administrators (TPAs) to obtain pre-authorization approvals for planned or emergency treatments, ensuring smooth patient admission and claim settlement.

Key Responsibilities:

Verify patient insurance details and eligibility before admission. Prepare and submit pre-authorization forms and required medical documents to the respective TPA/insurance company. Coordinate with treating doctors to gather diagnosis, treatment plan, and cost estimates. Follow up with insurance companies/TPAs for timely approval of pre-authorization requests. Update approval status in the hospital management system and inform the billing/admission desk. Handle queries related to pre-authorization approvals or denials. Maintain accurate records of all submitted and approved claims. Coordinate with the billing team for final claim submission post-discharge. Ensure compliance with hospital and TPA protocols.

Required Skills:

Good communication and coordination skills. Knowledge of health insurance policies and TPA procedures. Basic understanding of hospital billing and claim documentation. Proficiency in MS Office and hospital management software.

Qualification:

Any graduate.
Job Type: Full-time

Pay: From ?17,507.55 per month

Benefits:

Cell phone reimbursement Internet reimbursement * Provident Fund