Medical Insurance Expert
5 days ago
About Continental Hospitals:
We are a Joint Commission International (JCI) accredited tertiary care facility spanning across 18 floors, offering world-class healthcare services with a commitment to quality patient care. With 800 beds and over 60 specialties, we aim to redefine healthcare in India by delivering excellence with integrity, transparency, and evidence-based practices.
Job Title: Medical Insurance Manager
We are looking for an experienced Medical Insurance Manager to join our dynamic team at Continental Hospitals. The ideal candidate will have a strong understanding of medical insurance processes, Third Party Administrators (TPAs), and medical protocols.
Key Responsibilities:
- Claims Review & Management: Ensure accuracy, completeness, and adherence of medical insurance claims to policies and guidelines.
- TPA Coordination: Collaborate with Third Party Administrators (TPAs) for smooth claim processing and resolve any issues promptly.
- Patient Communication: Counsel and explain insurance coverage, claim processes, and address patient queries regarding treatment and claims.
- Claims Dispute Resolution: Resolve disputes related to claims, ensuring clear and timely communication with patients and insurance providers.
- Documentation & Reporting: Maintain accurate records of claims, queries, resolutions, and provide management with regular updates on claim status and related issues.
- Collaboration: Work closely with healthcare providers, insurance companies, and internal teams to streamline claims handling and ensure efficient operations.
- Training & Guidance: Provide training to staff on insurance processes and best practices for patient interaction.
Qualifications & Experience:
- Educational Qualification: M.Com or MBA, preferably with a focus in Finance or Insurance.
- Experience: Minimum 6 years of experience in medical insurance, claim management, or working with Third Party Administrators (TPAs).
- Background: Strong background in reviewing insurance claims and managing patient-related queries.
Skills & Competencies:
- Excellent communication and interpersonal skills to effectively engage with patients and insurance providers.
- Strong understanding of insurance claims processes with the ability to explain complex procedures clearly to patients.
- Ability to manage multiple tasks effectively and work under pressure.
- Proficiency in medical terminology and knowledge of healthcare procedures.
- Strong problem-solving abilities, with keen attention to detail.
- Empathetic, patient-focused approach to communication and interaction.
Estimated Salary: ₹1,200,000 - ₹1,500,000 per annum, depending on qualifications and experience.
Why Join Continental Hospitals?
As a leader in healthcare innovation and patient care, we offer an exciting and collaborative environment where you can make a meaningful impact. If you're passionate about providing exceptional service and contributing to our commitment to excellence, we invite you to explore this opportunity.
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