Insurance Executive (Male)

We Dr. Aravinds IVF Fertility and Pregnancy Centre hiring for an experienced insurance executive for our organization. Please find the JD below and Apply suitable candidates.

Role: Insurance Executive

Location: Tirupur, Tamil Nadu

Job: Full Time

Experience: 2years+

Location: Tirupur & Chennai

Job Summary:

The Insurance Executive is responsible for managing all aspects of insurance processing within the hospital, with a core focus on empanelment of the hospital with various insurance companies, Third-Party Administrators (TPAs), and government health schemes. This role ensures timely claim processing, accurate documentation, and maximized reimbursements through strategic insurer relationships.

Key Responsibilities:

• Empanelment:
• Initiate and manage empanelment processes with insurance companies, TPAs, and government health schemes (e.g., CGHS, ECHS, Ayushman Bharat, State Health Schemes).
• Prepare and submit required documents, applications, and compliance materials for empanelment.
• Liaise with authorities and insurers to ensure timely approvals and renewals.
• Maintain updated agreements, MOU records, and contract terms.
• Insurance Coordination:
• Verify patient insurance eligibility and obtain necessary authorizations.
• Ensure accurate billing and claim submission to insurers/TPAs.
• Follow up on pending, rejected, or underpaid claims with appropriate justifications.
• Coordinate with medical and billing teams for smooth pre-authorization and discharge documentation.
• Documentation & Reporting:
• Maintain detailed records of empanelment status, claims, and correspondence.
• Generate periodic reports on empanelment activities, claims performance, and insurer feedback.
• Ensure compliance with insurance guidelines and regulatory requirements.
• Relationship Management:
• Build and maintain strong professional relationships with insurance and TPA representatives.
• Address queries or grievances from insurers and ensure smooth claim settlements.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field.
• Minimum 1–2 years of experience in hospital insurance coordination, with hands-on empanelment experience.
• Strong knowledge of insurance procedures, claim processing, and government health schemes.
• Familiarity with ICD/CPT coding and medical billing software is a plus.
• Proficient in MS Office (Excel, Word) and hospital information systems (HIS).
• Excellent communication, negotiation, and documentation skills.

Job Type: Full-time

Pay: ₹15,000.00 - ₹18,000.00 per month

Benefits:

• Health insurance
• Provident Fund

Work Location: In person