Insurance Manager

1 week ago

Hyderabad, Telangana, India Hope Women's & Children's Hospital Full time

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.

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