Job Description

Key Responsibilities

1. Patient Insurance Handling

Explain cashless insurance / TPA procedures to patients and attendants Verify insurance eligibility, policy coverage, and exclusions Collect and check required documents (ID, insurance card, policy copy, referral letter, etc.)
2. Pre-Authorization & Approval

Prepare and submit pre-authorization requests for eye surgeries (cataract, retina, LASIK, glaucoma, etc.) Coordinate with doctors for clinical notes, diagnosis, and treatment plans Follow up with TPAs/insurance companies for timely approvals
3. Billing & Claims Coordination

Coordinate with billing department for package rates and itemized bills Ensure bills comply with TPA-approved rates and NABH guidelines (if applicable) Prepare and submit final claim documents after discharge Track claim status and follow up for payments and shortfalls
4. Documentation & Records

Maintain accurate patient insurance files and claim records Ensure proper documentation for audits and future references Handle denials, deductions, and clarifications raised by TPAs
5. Coordination & Communication

Act as a liaison between patients, doctors, nursing staff, billing team, and TPAs Update patients regularly on approval status and discharge formalities Handle patient queries related to insurance politely and empatheticall
Skills

Good knowledge of TPA & health insurance processes Familiarity with ophthalmology procedures & packages Strong communication and coordination skills Attention to detail and documentation accuracy Working knowledge of HIS / billing software
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Key Competencies

Patient-friendly attitude Ability to work under pressure Organized and follow-up oriented Ethical handling of confidential information
Job Type: Full-time

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

Work Location: In person