Insurance Executive

1 week ago

Tirupur, India Dr. Aravind's IVF Fertility & Pregnancy Centre Full time

We Dr. Aravinds IVF Fertility and Pregnancy Centre hiring for an experienced insurance executive for our organization. Please find the JD below and Apply suitable candidates.

Role: Insurance Executive

Location: Tirupur, Tamil Nadu

Job: Full Time

Experience: 2years+

Location: Tirupur & Chennai

Job Summary:

The Insurance Executive is responsible for managing all aspects of insurance processing within the hospital, with a core focus on empanelment of the hospital with various insurance companies, Third-Party Administrators (TPAs), and government health schemes. This role ensures timely claim processing, accurate documentation, and maximized reimbursements through strategic insurer relationships.

Key Responsibilities:

  • Empanelment:
  • Initiate and manage empanelment processes with insurance companies, TPAs, and government health schemes (e.g., CGHS, ECHS, Ayushman Bharat, State Health Schemes).
  • Prepare and submit required documents, applications, and compliance materials for empanelment.
  • Liaise with authorities and insurers to ensure timely approvals and renewals.
  • Maintain updated agreements, MOU records, and contract terms.
  • Insurance Coordination:
  • Verify patient insurance eligibility and obtain necessary authorizations.
  • Ensure accurate billing and claim submission to insurers/TPAs.
  • Follow up on pending, rejected, or underpaid claims with appropriate justifications.
  • Coordinate with medical and billing teams for smooth pre-authorization and discharge documentation.
  • Documentation & Reporting:
  • Maintain detailed records of empanelment status, claims, and correspondence.
  • Generate periodic reports on empanelment activities, claims performance, and insurer feedback.
  • Ensure compliance with insurance guidelines and regulatory requirements.
  • Relationship Management:
  • Build and maintain strong professional relationships with insurance and TPA representatives.
  • Address queries or grievances from insurers and ensure smooth claim settlements.

Qualifications:

  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field.
  • Minimum 1–2 years of experience in hospital insurance coordination, with hands-on empanelment experience.
  • Strong knowledge of insurance procedures, claim processing, and government health schemes.
  • Familiarity with ICD/CPT coding and medical billing software is a plus.
  • Proficient in MS Office (Excel, Word) and hospital information systems (HIS).
  • Excellent communication, negotiation, and documentation skills.

Job Type: Full-time

Pay: ₹18, ₹22,000.00 per month

Benefits:

  • Health insurance
  • Provident Fund

Work Location: In person

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