Insurance Manager

About Us:

Hope Women’s and Children’s Hospital is a leading 100-bedded multispecialty facility in Telangana, dedicated to providing exceptional care for women and children. With advanced departments including NICU, PICU, Modular OT, and a 24/7 Emergency & Ambulance Service, we are committed to clinical excellence and operational efficiency.

Position Overview:

We are looking for a detail-oriented and experienced Insurance Manager to lead and streamline our insurance processes. The ideal candidate will be responsible for managing end-to-end insurance operations, ensuring smooth coordination between TPA, patients, and internal departments.

Key Responsibilities:

• Handle end-to-end coordination with TPAs, insurance companies, and empanelment agencies.
• Oversee pre-authorization, claim submission, and follow-up of pending claims.
• Ensure timely settlement of claims and maintain accurate documentation.
• Coordinate with the billing and finance team for insurance patient billing.
• Track reimbursement status and generate periodic MIS reports.
• Manage and update hospital empanelments and TPA agreements.
• Train front office and billing staff on insurance procedures and documentation.
• Address patient queries and grievances related to insurance coverage and processing.

Requirements:

• Graduate in any discipline (MBA in Hospital Administration/Finance preferred).

• Prior hospital experience is a must.

• Minimum 5 years of relevant experience in hospital insurance management.
• Strong knowledge of TPA processes, pre-auth, and claim settlement workflows.
• Good communication skills and ability to coordinate with patients and insurers.
• Proficiency in Excel, email communication, and hospital software systems.