Insurance Executive

Job Description

Position Overview: The Hospital Insurance Executive plays a crucial role in managing insurance claims, verifying patient coverage, and ensuring smooth communication between the hospital and insurance providers. You will work closely with both patients and the hospital's billing and finance departments to ensure that all insurance-related matters are handled efficiently, accurately, and in a timely manner. Key Responsibilities: Insurance Verification: Verify patient insurance coverage and eligibility prior to treatment, ensuring that all necessary approvals and authorizations are obtained. Claims Management: Submit insurance claims, follow up on pending claims, and resolve any discrepancies or issues that may arise during the claims process. Billing Support: Work with the billing department to ensure that all patient charges are accurately reflected on insurance claims and that all insurance payments are properly processed. Patient Communication: Communicate with patients regarding their insurance coverage, co-pays, deductibles, and out-of-pocket expenses, providing clear and helpful information. Documentation: Maintain accurate records of insurance verifications, claims submissions, payment status, and communication with insurance providers and patients. Insurance Liaison: Serve as the primary point of contact between the hospital and insurance companies, addressing inquiries, negotiating reimbursements, and ensuring that the hospital's insurance agreements are adhered to. Compliance: Ensure that all insurance practices comply with hospital policies, industry regulations, and state/federal guidelines (e.g., HIPAA, Medicare, Medicaid). Dispute Resolution: Assist in resolving insurance-related disputes, including claims denials, underpayments, and overpayments, ensuring timely and fair resolutions. Job Types: Full-time, Permanent Benefits: Provident Fund Schedule: Day shift Supplemental Pay: Yearly bonus Work Location: In person