Job Summary:

The Insurance Executive will be responsible for managing all activities related to patient insurance — including pre-authorization, claim processing, billing coordination, and liaison with insurance companies and TPAs. The role ensures accurate documentation, timely follow-up, and smooth coordination between patients, clinical teams, and insurers.

Key Responsibilities:

• Coordinate with insurance companies and TPAs for pre-authorization approvals.
• Verify patient eligibility and insurance coverage prior to admission.
• Collect and submit necessary documents for pre-authorization and final claims.
• Ensure correct coding (ICD, procedure codes) and documentation for claim processing.
• Maintain communication between patients, doctors, and insurance desks for status updates.
• Track and follow up on pending claims, rejections, or queries.
• Prepare and maintain daily insurance MIS reports.
• Assist in billing and discharge processes for insured patients.
• Support cashless and reimbursement claim procedures.
• Ensure compliance with hospital and insurance policies at all times.

Qualifications & Skills:

For Freshers:

• Bachelor’s degree in any discipline (preferably in commerce, healthcare management, or related fields).
• Good communication and interpersonal skills.
• Basic knowledge of MS Office (Word, Excel).
• Eagerness to learn hospital insurance processes.

For Experienced Candidates:

• 1–3 years of experience in hospital insurance desk operations or TPA coordination.
• Familiarity with pre-authorization, claim submission, and insurance software portals.
• Strong follow-up and documentation skills.
• Knowledge of TPA networks and corporate insurance policies.

Key Competencies:

• Attention to detail
• Customer service orientation
• Team coordination
• Time management
• Problem-solving attitude