Cancer Care Specialist

3 days ago

Delhi, Delhi, India beBeeCompliance Full time ₹ 1,20,00,000 - ₹ 2,25,00,000

About us:

We are a company that is dedicated to making world-class treatment more accessible, patient-centric, and closer to home.

We have smaller, strategically located oncology centers focused on early diagnosis, daycare chemotherapy, and surgical oncology. This helps eliminate logistical and emotional barriers to cancer care for millions of patients in India.

Our role involves ensuring all hospital operations comply with regulatory frameworks while driving empanelment with TPAs, insurance providers, and government health schemes. We manage licenses, handle empanelment documentation, resolve claim issues, and ensure smooth recoveries.

This role enables patient acquisition through empanelment channels. It requires managing hospital and clinical licenses, including drug license, pollution control, biomedical waste, fire safety, lift NOCs, and AERB compliance. We track and ensure timely renewals of all mandatory approvals and registrations.

We coordinate with legal advisors, auditors, and regulatory authorities for audits, assessments, and inspections. Our team drafts, reviews, and maintains MoUs, contracts, and other legal documentation. We build and maintain compliance dashboards for leadership & Insurance Management.

The Compliance & Empanelment Lead will play a pivotal role in this process. They will lead empanelments with TPAs, private insurers, GIPSA, PSU insurers, CGHS, ECHS, ESI, and other government health panels. We manage empanelment documentation, application submissions, negotiations, and timely renewals.

Maintaining updated databases of empanelment status, rate contracts, and TPA agreements is crucial. The Compliance & Empanelment Lead resolves empanelment queries, escalations, and supports clinic operations teams in leveraging empanelments for patient inflow.

We track payment cycles and coordinate with TPAs and insurers to ensure timely settlement of claims. Investigating and resolving claim discrepancies, rejections, and denials ensures maximum recovery. Maintaining MIS reports on empanelment progress, claim settlements, and outstanding dues is essential.

This role requires strong negotiation, documentation, and stakeholder management skills. Proficiency in claim processing, rejections handling, and TPA interactions is necessary. The ability to coordinate cross-functionally with clinical, finance, legal, and operations teams is vital. High attention to detail and the ability to thrive in a fast-paced, scaling healthcare environment are also required.

Requirements:

  • Bachelors degree is mandatory; LL.B preferred.
  • 5-7 years of experience in hospital compliance, empanelment, or liaison roles.
  • Prior experience in multispecialty hospitals, oncology centers, or TPA/insurance companies highly desirable.

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