Executive TPA Insurance

As a Claim Coordinator, your primary responsibility will be to coordinate with various TPAs and insurance companies for claim processing and approvals. This includes verifying insurance documents, policy details, and patient eligibility. You will also assist in pre-authorization and cashless treatment approvals for insured patients. Your role will involve following up on pending claims, rejections, and reimbursements, ensuring that accurate and updated records of all insurance-related transactions and documentation are maintained. Key Responsibilities: - Coordinate with TPAs and insurance companies for claim processing and approvals - Verify insurance documents, policy details, and patient eligibility - Assist in pre-authorization and cashless treatment approvals for insured patients - Follow up on pending claims, rejections, and reimbursements - Maintain accurate and updated records of all insurance-related transactions and documentation - Liaise with hospital billing departments and patient relations teams for timely submission of required documents - Address patient and internal queries related to insurance coverage, policies, and procedures - Prepare MIS reports on claim status, turnaround times (TAT), and escalations - Ensure compliance with IRDA regulations and internal SOPs Qualifications Required: - Previous experience in insurance claims coordination or related field - Strong understanding of insurance policies, procedures, and regulations - Excellent communication and interpersonal skills - Ability to multitask and prioritize workload effectively - Proficiency in MS Office applications - Knowledge of IRDA regulations is a plus In addition to the job responsibilities and qualifications, the company offers the following benefits: - Health insurance - Paid time off - Provident Fund Please note that this is a full-time position with rotational shifts, and the work location is in person. As a Claim Coordinator, your primary responsibility will be to coordinate with various TPAs and insurance companies for claim processing and approvals. This includes verifying insurance documents, policy details, and patient eligibility. You will also assist in pre-authorization and cashless treatment approvals for insured patients. Your role will involve following up on pending claims, rejections, and reimbursements, ensuring that accurate and updated records of all insurance-related transactions and documentation are maintained. Key Responsibilities: - Coordinate with TPAs and insurance companies for claim processing and approvals - Verify insurance documents, policy details, and patient eligibility - Assist in pre-authorization and cashless treatment approvals for insured patients - Follow up on pending claims, rejections, and reimbursements - Maintain accurate and updated records of all insurance-related transactions and documentation - Liaise with hospital billing departments and patient relations teams for timely submission of required documents - Address patient and internal queries related to insurance coverage, policies, and procedures - Prepare MIS reports on claim status, turnaround times (TAT), and escalations - Ensure compliance with IRDA regulations and internal SOPs Qualifications Required: - Previous experience in insurance claims coordination or related field - Strong understanding of insurance policies, procedures, and regulations - Excellent communication and interpersonal skills - Ability to multitask and prioritize workload effectively - Proficiency in MS Office applications - Knowledge of IRDA regulations is a plus In addition to the job responsibilities and qualifications, the company offers the following benefits: - Health insurance - Paid time off - Provident Fund Please note that this is a full-time position with rotational shifts, and the work location is in person.