Insurance Officer

3 days ago

Aurangabad, India Kamalnayan Bajaj Hospital, Beed Bypass, Aurangabad. Full time

Co-ordinate with Medical officer for Authorization form.
- To verify all documents before sending pre-auth form. To Ensure smooth functioning of insurance process, below mentioned procedures should be followed without fail
- Ensure deposit amount before pre authorization.
- Ensure to collect Non-Medical Items, Co-Payment and Short approval before discharge.
- Document to be attached with Pre-auth:

- Pre-auth Form duly filled, Insurance Card / Policy Copy / Policy Number / ID Number / KYC, Patient’s ID Proof, Patient’s Case Paper or Initial Assessment Timely reply to queries to TPA/Insurance Companies
- Inform Consultant & Patient’s relative as & when required. Keep them updated about status of claim being processed
- Co-ordination with billing team on daily basis for cashless patient’s bills and to ensure additional approval in case of enhancement required
- Coordination with various departments such as billing, Radiology, Pathology etc. for cashless processing
- Ensure to update excel tracker of all insurance case on daily basis without fail
- Timely submission of hard copy of the documents to the TPA / Insurance companies. Maximum by next day evening. In case of no submission claim may get rejected / closed and we will be in financial lose.
- Ensure proper documentation and filing of the same for future reference and in case of conflicts.
- Follow up with TPA / Insurance companies in case of payment not received in 30 Days.
- Ensure timely reply in case of deficiency raised by the insurance companies post hard copy of file submitted to then. Maximum TAT is 1 Day.
- Ensure to book payment received from insurance TPA / companies in system on daily basis.
- Coordinate with the patient and finance team to arrange refund once final bill settled with insurance company.
- Completion of reimbursement file of the patient (Govt. Employees / Those who are not covered under insurance). TAT is 48 Working Hours.
- We are extending cashless facilities to those corporate companies with whom we are having tie-up.
- Ensure to submit Final Bill along with all required documents to the Corporate, once patient discharge from the hospital.

**Qualification**: Graduation(12+3)/PG

**Experience**: 8-10 Years Experience in relevant field

**Job specific knowledge and competencies**:

- Ability to understand the customer needs
- Ability to handle insurance documents
- Ability to process claims within TAT

**Skill**
- Communication skills.
- Problem solving abilities
- Interpersonal skill & teamwork
- Quality Focus, Time Management
- multi-tasking

**Salary**: ₹25,000.00 - ₹35,000.00 per month

Schedule:

- Evening shift
- Morning shift

Ability to commute/relocate:

- Aurangabad, Maharashtra: Reliably commute or planning to relocate before starting work (required)

**Experience**:

- total work: 1 year (preferred)

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