Insurance Executive

1 day ago

Chitradurga KA IN Sarji Vedaantha Hospital Full time

Job Summary The Insurance Executive is responsible for managing all insurance-related operations within Sarji Vedaanth Hospital ensuring smooth coordination between patients insurance providers and hospital departments This role focuses on claim processing authorization management billing coordination and ensuring compliance with insurance policies and regulatory requirements The Insurance Executive plays a key role in enhancing the patient experience by ensuring timely approvals and accurate claim settlements Key ResponsibilitiesInsurance Coordination Coordinate with various insurance companies and Third-Party Administrators TPAs for patient admissions pre-authorization and claim approvals Verify patient insurance eligibility coverage limits policy terms and required documentation Pre-Authorization Claims Management Prepare and submit pre-authorization requests for planned and emergency procedures Monitor approval status and follow up promptly to avoid delays in patient care Manage end-to-end claims process including documentation filing tracking and settlement Address claim queries and discrepancies from insurance providers Billing Documentation Work closely with the billing team to ensure accurate and complete documentation for claim submission Maintain updated patient files medical records and supporting documents required for audits Ensure coding accuracy ICD CPT procedure codes in coordination with the medical and billing teams Compliance Quality Assurance Ensure adherence to hospital policies insurance guidelines and regulatory requirements Stay updated on changes in insurance policies TPA guidelines and tariffs Support internal and external audits related to insurance and billing Patient Stakeholder Communication Educate patients and families about insurance coverage exclusions and financial responsibilities Provide timely updates to patients on authorization status and claim progress Build strong relationships with insurance representatives and TPAs Coordination with Internal Departments Liaise with doctors nursing staff billing and admission teams to ensure smooth workflow Escalate bottlenecks or operational challenges to management for timely resolution Job Types Full-time Fresher Pay 10 838 10 - 20 000 00 per month Benefits Health insurance Life insurance Provident Fund Ability to commute relocate Chitradurga Karnataka Reliably commute or planning to relocate before starting work Preferred Education Bachelor s Preferred Experience Expert 2 years Preferred Language Kannada English Preferred Location Chitradurga Karnataka Preferred Shift availability Day Shift Preferred Work Location In person

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