Insurance Executive

2 days ago

Vellore, Tamil Nadu, India Nexus Consulting Solutions Full time ₹ 1,20,000 - ₹ 3,38,064 per year

Job Title: Insurance Executive – Hospital Experience Required: 2 to 3 Years Department: Billing & Insurance / TPA Reporting To: Insurance / Billing Manager Key Responsibilities: Coordinate with insurance companies, TPAs, and corporate clients for pre-authorization and claim approvals. Review patient documents, diagnosis codes, and ensure accurate submission of insurance claims. Process cashless approvals, reimbursement claims, and discharge intimation within defined timelines. Verify insurance eligibility and policy coverage before admission. Maintain and update patient insurance records and ensure all documentation is complete and accurate. Follow up on pending approvals, queries, shortfall documents, and claim settlements till closure. Coordinate with the billing, admission, and discharge teams to ensure smooth insurance workflows. Monitor and handle denied or rejected claims, ensuring timely resubmission with proper justifications. Prepare and submit daily MIS reports on claim status, approvals, and outstanding cases. Maintain strong relationships with TPA coordinators and corporate desk representatives. Ensure compliance with hospital policies and IRDA/TPA guidelines.
--- Required Skills & Competencies: Strong understanding of TPA processes, medical insurance policies, and cashless procedures. Knowledge of ICD codes and medical terminology will be an added advantage. Proficiency in claim documentation and follow-up protocols. Excellent communication and coordination skills. Ability to work under pressure and handle multiple cases simultaneously. Proficient in MS Excel / Hospital Billing Software / TPA Portal Handling.
--- Qualification: Graduate in Any Discipline (Preferred: BBA, B.Com, Hospital Administration, or related field). Certification or prior training in medical insurance billing will be an added advantage.
--- Preferred Profile: Experience working in Hospital TPA / Insurance Desk is mandatory. Candidates with 2–3 years of hands-on experience in insurance coordination, claim processing, or reimbursement handling.
--- Key Attributes: Detail-oriented with strong follow-up ability Patient handling & counselling skills Professional attitude and team coordination

Job Types: Full-time, Permanent

Pay: ₹10, ₹28,134.47 per month

Benefits:

  • Health insurance
  • Leave encashment
  • Life insurance
  • Paid sick time
  • Provident Fund

Work Location: In person

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