Job Description

Pre-Admission & Admission

:

Collect and verify insurance documents from patients. Coordinate with treating doctors for necessary documents (e.g., diagnosis, treatment plan). Initiate pre-authorization process with TPA/insurance companies. Follow up for approval and ensure timely admission under cashless treatment.
2.

During Hospitalization

:

Maintain communication with TPAs for interim approvals/extensions as required. Ensure all procedures or treatments are approved and documented properly. Maintain accurate records of approvals and patient documents.
3.

Discharge Process

:

Submit final bill and discharge summary to the insurance company/TPA. Follow up for final approval and inform the billing department. Ensure patient discharge only after approval or necessary payment clearance.
4.

Post-Discharge & Reimbursement

:

Support patients in submitting reimbursement claims. Coordinate with TPA for follow-ups on pending claims. Maintain detailed MIS for claim submissions, approvals, rejections, and pending cases.
5.

Documentation & Compliance

:

Maintain confidentiality and accuracy in all insurance-related documents. Ensure compliance with hospital policies. Liaise with internal departments for audits and compliance checks.

Required Skills & Qualifications

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Graduate in any discipline (preferably in Healthcare or Insurance). 2-5 years of experience in TPA/insurance coordination in a hospital setting. Good understanding of health insurance processes and documentation. Strong communication and interpersonal skills. Proficiency in MS Office and hospital information systems (HIS). Ability to handle stress and multitask in a fast-paced environment.

Preferred

:

Certification in Hospital Administration or Health Insurance. Experience with major TPAs and knowledge of cashless claim platforms.

25-30k/month

candidate can call-9630196021, 9425503700

Job Type: Full-time

Work Location: In person