Healthcare Operations Manager

2 days ago


Mumbai, Maharashtra, India Impact Guru Technology Ventures Pvt Ltd Full time

About the Role:

The Healthcare Operations Manager will drive CarePal Group's trust and safety strategy, overseeing hospital coordination, insurance claim processing, and TPA operations. This role demands a strong experience in setting and running processes in the healthcare insurance domain, including patient admission and discharge, billing verification, risk mitigation, and fraud prevention.

Key Responsibilities:

  • Manage relationships with hospital billing departments to ensure seamless service coordination.
  • Oversee admission, discharge, and cost verification processes, ensuring adherence to CarePal's pricing agreements.
  • Lead efforts to streamline billing accuracy, end-to-end claim processing, optimize reconciliation processes, and enhance the patient experience.

Billing Verification & Reconciliation:

  • Conduct cost verification and reconciliation with hospital billing & Finance teams to prevent discrepancies and ensure adherence to agreed rates.
  • Develop structured reconciliation processes to accurately track and validate patient costs.
  • Identify opportunities for cost-saving and process improvement in billing workflows.

Patient Journey & Health Insurance Coordination:

  • Oversee the full patient journey from admission through discharge, ensuring compliance with healthcare insurance guidelines.
  • Coordinate with TPA and hospital teams for seamless admission, discharge, and insurance claim processes.
  • Ensure all insurance-related processes are efficient, accurate, and meet regulatory standards.

Expected Salary: $120,000 - $180,000 per year



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