Mediclaim Executive

6 months ago

Ahmedabad, India Dr.Jivraj Mehta Smarak Health Foundation , Bakeri Medical Research Centre Full time

**Job Description: Mediclaim Executive**

**Key Responsibilities**:
**1. Insurance Verification**:

- Verify patients' insurance coverage and eligibility for various medical procedures and treatments.
- Coordinate with insurance companies to gather necessary information and ensure accurate coverage details.
- Explain insurance benefits and coverage limitations to patients and their families.

**2. Pre-authorization and Documentation**:

- Initiate the pre-authorization process for planned medical procedures, surgeries, and treatments.
- Prepare and submit required documentation to insurance companies for pre-approval.
- Collaborate with medical staff to provide necessary medical records and supporting documents.

**3. Claims Processing**:

- Assist patients in submitting insurance claims by providing accurate information and documentation.
- Monitor the status of claims and follow up with insurance companies to ensure timely processing.
- Address any claim denials, discrepancies, or rejections, and work to resolve them.

**4. Patient Communication**:

- Maintain clear and open communication with patients regarding their insurance coverage, claims, and related financial matters.
- Address patient queries and concerns about insurance billing and coverage.

**5. Coordination with Medical Teams**:

- Collaborate with medical professionals to ensure that the necessary medical records and documentation are provided for insurance purposes.
- Coordinate with doctors, nurses, and other healthcare staff to gather relevant medical information required for insurance claims.

**6. Compliance and Regulations**:

- Stay updated with insurance industry regulations, policy changes, and best practices.
- Ensure compliance with all legal and regulatory requirements related to insurance and billing processes.

**7. Data Management**:

- Maintain accurate and organized records of insurance-related information, claims, and documentation.
- Utilize hospital information systems to track and manage insurance-related data.

**8. Financial Assistance**:

- Assist patients in understanding the financial aspects of their medical treatments, including deductibles, co-pays, and out-of-pocket expenses.
- Provide guidance on available financial assistance programs or options for patients who may face financial challenges.

**9. Team Collaboration**:

- Collaborate with other hospital departments, such as billing, finance, and front desk, to streamline insurance-related processes.
- Participate in training sessions and knowledge sharing to enhance the overall understanding of insurance processes within the hospital.

**Job Types**: Full-time, Permanent

**Salary**: Up to ₹20,000.00 per month

**Benefits**:

- Flexible schedule
- Leave encashment
- Paid sick time
- Paid time off
- Provident Fund

Schedule:

- Day shift
- Rotational shift
- Weekend availability

Ability to commute/relocate:

- Ahmedabad, Gujarat: Reliably commute or planning to relocate before starting work (required)

**Experience**:

- total work: 1 year (preferred)

**Speak with the employer**
+91 9338533666

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