Insurance Executive - Hospital

Name of the Position : Insurance Executive

Educational Requirements: MBA/MHA/MSW

Experience: Prior experience in insurance handling

Preferably Female Candidates

Key Responsibilities:

• Insurance Verification:
• Verify patients’ insurance coverage and benefits before treatment or hospitalization.
• Ensure accurate eligibility and pre-authorization requirements for procedures.
• Claims Management:
• Prepare, review, and submit insurance claims accurately and in a timely manner.
• Follow up on submitted claims to ensure they are processed and paid promptly.
• Coordination with Insurance Providers:
• Liaise with insurance companies to resolve claim denials, disputes, or discrepancies.
• Maintain up-to-date knowledge of insurance policies, procedures, and coding standards.
• Patient Interaction:
• Explain insurance coverage and out-of-pocket costs to patients.
• Address patient queries related to insurance claims and billing.
• Documentation and Reporting:
• Maintain records of insurance claims, approvals, and rejections.
• Generate periodic reports on claim statuses and reimbursement trends for hospital management.
• Compliance and Regulations:
• Ensure adherence to healthcare laws, insurance regulations, and hospital policies.
• Stay updated with changes in insurance policies, medical coding, and government regulations.
• Billing Support:
• Assist the billing department in preparing patient bills based on insurance coverage.
• Handle coordination for co-payments, deductibles, and other patient responsibilities.
• Problem-Solving:
• Address and resolve issues such as claim rejections, underpayments, or coding errors.
• Coordinate appeals for denied claims.

Job Type: Full-time

Pay: ₹20,000.00 - ₹25,000.00 per month

Work Location: In person