Pre Authorization

3 days ago

Chennai, Tamil Nadu, India Vizza Fintech Private Limited Full time ₹ 2,10,684 - ₹ 3,50,000 per year

Job Summary:

The Pre-Authorization Executive is responsible for handling insurance-related processes for patients admitted under health insurance coverage. The role involves coordinating with doctors, patients, and Third-Party Administrators (TPAs) to obtain pre-authorization approvals for planned or emergency treatments, ensuring smooth patient admission and claim settlement.

Key Responsibilities:

  • Verify patient insurance details and eligibility before admission.
  • Prepare and submit pre-authorization forms and required medical documents to the respective TPA/insurance company.
  • Coordinate with treating doctors to gather diagnosis, treatment plan, and cost estimates.
  • Follow up with insurance companies/TPAs for timely approval of pre-authorization requests.
  • Update approval status in the hospital management system and inform the billing/admission desk.
  • Handle queries related to pre-authorization approvals or denials.
  • Maintain accurate records of all submitted and approved claims.
  • Coordinate with the billing team for final claim submission post-discharge.
  • Ensure compliance with hospital and TPA protocols.

Required Skills:

  • Good communication and coordination skills.
  • Knowledge of health insurance policies and TPA procedures.
  • Basic understanding of hospital billing and claim documentation.
  • Proficiency in MS Office and hospital management software.

Qualification:

  • Any graduate.

Job Type: Full-time

Pay: From ₹17,507.55 per month

Benefits:

  • Cell phone reimbursement
  • Internet reimbursement
  • Provident Fund

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