Medical Insurance jobs

• Verify patients’ insurance eligibility, coverage, policy details, and benefits at the time of admission.
• Obtain and process pre-authorisation requests for planned and emergency admissions/procedures.
• Coordinate with insurance companies and TPAs regarding approvals, queries, and additional requirements.
• Collect and verify all necessary documents required for insurance claims.
• Prepare and submit accurate claim documents within the prescribed timelines.
• Coordinate with doctors, nursing staff, billing, medical records, and other departments for required clinical and billing documentation.
• Follow up on pending pre-authorisations, claim approvals, queries, and settlements.
• Review discharge summaries, investigation reports, prescriptions, bills, and other documents for completeness before claim submission.
• Communicate with patients and their attendants regarding insurance procedures, approvals, exclusions, deductibles, and non-payable amounts.
• Handle insurance queries and resolve discrepancies in coordination with the concerned departments.
• Maintain proper records of submitted claims, approvals, rejections, deductions, and settlements.
• Monitor outstanding insurance claims and regularly follow up with TPAs/insurance companies.
• Assist in identifying reasons for claim rejection or deduction and take corrective action.
• Ensure compliance with hospital policies, insurance guidelines, and applicable regulatory requirements.
• Maintain confidentiality of patient and insurance-related information.
• Prepare daily/weekly/monthly reports related to insurance admissions, approvals, claims, rejections, and pending settlements.
• Perform any other duties assigned by the reporting manager or hospital administration.

Pay: ₹25,000.00 - ₹35,000.00 per month

Work Location: In person