INSURANCE COORDINATOR

Role Overview:

The Insurance Coordinator is responsible for managing and coordinating all insurance-related activities within the hospital. This includes verifying patient insurance coverage, processing claims, and ensuring effective communication between patients, healthcare providers, and insurance companies. The Insurance Coordinator plays a vital role in facilitating the claims process and ensuring a smooth experience for patients regarding their insurance benefits.

Key Responsibilities:

• Insurance Verification:
• Verify patient insurance coverage and benefits prior to admission or treatment.
• Ensure that all necessary pre-authorizations are obtained for procedures and services as required by insurance companies.
• Claims Processing:
• Assist in preparing and submitting insurance claims for inpatient and outpatient services, ensuring accuracy and compliance with insurance requirements.
• Monitor the status of claims and follow up on outstanding claims with insurance providers.
• Patient Assistance:
• Act as the primary point of contact for patients regarding insurance inquiries, benefits, and claims status.
• Provide clear explanations to patients about their insurance coverage, payment responsibilities, and the claims process.
• Documentation and Record Keeping:
• Maintain accurate and organized records of insurance verifications, claims submissions, and correspondence with insurance companies.
• Ensure all documentation is up-to-date and readily available for audits and compliance checks.
• Collaboration with Healthcare Providers:
• Work closely with clinical departments to ensure accurate coding and documentation for all services rendered to patients.
• Collaborate with billing staff to ensure that all necessary information is captured for timely claims processing.
• Dispute Resolution:
• Address and resolve any discrepancies or issues related to insurance claims or patient billing inquiries.
• Communicate effectively with insurance companies to clarify issues and seek resolutions for denied or delayed claims.
• Reporting:
• Assist in preparing reports on insurance claims, including metrics related to approval rates, denials, and outstanding claims.
• Provide feedback to the Insurance Manager regarding trends or issues encountered in the claims process.
• Compliance:
• Ensure compliance with hospital policies, regulations, and insurance company requirements regarding claims processing.
• Stay updated on changes in healthcare laws and insurance policies that may affect the hospital's operations.

Job Type: Full-time

Pay: From ₹10,000.00 per month

Work Location: In person