Job Description

Claim Management:

Processing, verifying, and coordinating all aspects of cashless and reimbursement insurance claims from admission to discharge.

Coordination:

Liaising with patients, hospital staff (billing, doctors), and insurance companies/TPAs.

Documentation:

Ensuring all medical files and documents are complete, accurate, and submitted as required, managing hard copies and TPA portals.

Authorizations:

Obtaining pre-authorizations and referrals for treatments from insurers.

Billing:

Preparing split bills, updating implant bills, and reconciling with the billing department.

Follow-up:

Daily follow-ups with TPAs for claim approvals and outstanding payments.

Compliance:

Adhering to TPA, HMO, PPO, and state program guidelines and regulations.

Reporting:

Preparing monthly reports and handling post-sales service.
Essential Skills & Qualification

Graduation with relevant Experience

Job Type: Full-time

Pay: ₹30,000.00 - ₹40,000.00 per month

Work Location: In person