Tagore Educational Trust

Role & responsibilities Coordinate with all TPAs and insurance companies for cashless and reimbursement claims. Follow up for enhancement approvals during treatment and resolve TPA queries immediately. Manage final authorization and discharge approval process without delay. Verify patient eligibility, policy coverage, exclusions, room rent compliance, and package details. Coordinate with billing department to ensure accurate estimation and final bill preparation. Ensure proper documentation: discharge summary, investigation reports, bills, and claim forms. Reduce claim rejections by ensuring 100% accuracy in documents and coding. Maintain daily MIS reports on cashless approvals, pending cases, rejections, and follow-ups. Handle patient counseling regarding policy coverage, approval status, and required documents. Ensure compliance with hospital insurance SOPs and audit requirements.