Manager Insurance

2 weeks ago

Hyderabad, India Whatjobs IN C2 Full time

Continental Hospitals, Gachibowli, Hyderabad Continental Hospital is a JCI and NABH accredited facility offering multi-specialty, tertiary, and quaternary care services with more than 56 specialties, the healthcare institution is spread across 18 floors (1.4 million sq. ft), located in the IT and Financial District of Hyderabad, Gachibowli. Continental Hospitals was founded by Dr Guru N Reddy in April 2013 to redefine healthcare in India by providing quality patient care with integrity, transparency, a collaborative approach, and evidence-based medicine Continental Hospitals, India’s first LEED qualified super specialty hospital is built on international standards and is designed to enhance the healing spaces with natural ventilation, safety, and privacy. The hospital has incorporated the safest standards in the world including fire, water resources, sanitation, and internal transportation systems. Continental Hospitals has a special health check lounge and a dedicated area for international patients, state-of-the-art facilities and medical equipment, as well as the latest communication and information technology. Key specialties include Gastroenterology, Oncology, Orthopedics, Neuroscience, Cardiology, and Multi-organ Transplants. Our proactive team of highly experienced doctors, nurses, and staff ensures that we deliver the highest standard of personalized care to our patients at all times. Location: Continental Hospitals, Nanakramguda, Financial Distt, Hyderabad Department: Insurance / Revenue Cycle Management Qualification: MBBS Experience: Minimum 7 + years (preferably in hospital or TPA/insurance coordination) Job Summary: The Medical Underwriter will be responsible for reviewing, interpreting, and evaluating patient cases from a clinical and insurance perspective. The role involves coordinating with insurance companies, clarifying clinical queries, handling claim denials, and ensuring seamless communication between the hospital and payers. Key Responsibilities: Review patient records and medical documents to assess insurance eligibility and claim justifications Coordinate with insurance companies for pre-authorizations, approvals, and documentation Respond to queries, clarifications, and information requests from insurance providers Handle claim denials, re-submissions, and justification letters with accurate clinical input Maintain proper documentation and correspondence through email and hospital systems Liaise with treating consultants to gather necessary clinical details for underwriting Ensure compliance with insurance policies and hospital SOPs Work closely with billing, admission, and discharge teams for timely processing Required Skills: Strong understanding of clinical terminology and hospital procedures Excellent written and verbal communication skills Proficient in handling medical correspondence and insurance queries Ability to multitask, prioritize, and manage time efficiently Familiarity with TPA processes, hospital information systems, and claim workflows is an advantage

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