Hospital Cashless Manager

Job Description

Riti eye care hospital is looking for a Cashless manager for it's corporate office at Lucknow o facilitate and manage the cashless claims process within a hospital, ensuring smooth and efficient operations related to insurance claims and reimbursements. They handle all aspects of the cashless claims process, from initial inquiries to final settlement. This includes coordinating with patients, insurance companies, and hospital staff to ensure accurate and timely processing of claims. Key Responsibilities of a Hospital Cashless Manager: Claims Processing: Managing the entire cashless claims cycle, from pre-authorization to final settlement. Verifying patient eligibility, insurance coverage, and policy details. Preparing and submitting claims to insurance companies, ensuring accuracy and adherence to guidelines. Monitoring claim status and resolving any issues or discrepancies Communication and Coordination: Communicating with patients, insurance companies, and other stakeholders to update them on claim status. Coordinating with hospital departments, such as billing and finance, to ensure smooth claim processing. Providing guidance and support to patients on cashless procedures and insurance policies. Relationship Management: Building and maintaining strong relationships with insurance companies and Third-Party Administrators (TPAs). Negotiating favorable terms and conditions with insurance providers. Ensuring compliance with regulatory requirements and industry standards. Data Management and Reporting: Maintaining accurate records of cashless claims and reimbursements. Generating reports on claim volume, cost, and other key performance indicators. Identifying trends and patterns in claims data to improve processes and reduce costs. Problem Solving: Identifying and resolving issues related to cashless claims, such as claim denials or delays. Developing and implementing solutions to improve the efficiency and effectiveness of the cashless claims process. Required Skills and Qualifications: Experience: Relevant experience in health insurance claims management, preferably with a focus on cashless claims. Knowledge: Strong understanding of health insurance policies, claims processing procedures, and regulatory requirements. Skills: Excellent communication, interpersonal, and problem-solving skills. Software Proficiency: Competency in using healthcare management software and billing systems. Education: Bachelor's or Master's degree in a related field is often preferred. Job Type: Full-time Pay: ₹25,000.00 - ₹30,000.00 per month Schedule: Day shift Education: Master's (Preferred) Experience: Cashless manager: 5 years (Required) Location: Lucknow, Uttar Pradesh (Preferred) Willingness to travel: 25% (Preferred) Work Location: In person Expected Start Date: 01/06/2025