Insurance Executive

2 weeks ago

Tiruppur, Tamil Nadu, India Dr. Aravind's IVF Fertility & Pregnancy Centre Full time ₹ 1,80,000 - ₹ 2,20,000 per year

We Dr. Aravinds IVF Fertility and Pregnancy Centre hiring for an experienced insurance executive for our organization. Please find the JD below and Apply suitable candidates.

Role: Insurance Executive

Location: Tirupur, Tamil Nadu

Job: Full Time

Experience: 2years+

Location: Tirupur & Chennai

Job Summary:

The Insurance Executive is responsible for managing all aspects of insurance processing within the hospital, with a core focus on empanelment of the hospital with various insurance companies, Third-Party Administrators (TPAs), and government health schemes. This role ensures timely claim processing, accurate documentation, and maximized reimbursements through strategic insurer relationships.

Key Responsibilities:

  • Empanelment:
  • Initiate and manage empanelment processes with insurance companies, TPAs, and government health schemes (e.g., CGHS, ECHS, Ayushman Bharat, State Health Schemes).
  • Prepare and submit required documents, applications, and compliance materials for empanelment.
  • Liaise with authorities and insurers to ensure timely approvals and renewals.
  • Maintain updated agreements, MOU records, and contract terms.
  • Insurance Coordination:
  • Verify patient insurance eligibility and obtain necessary authorizations.
  • Ensure accurate billing and claim submission to insurers/TPAs.
  • Follow up on pending, rejected, or underpaid claims with appropriate justifications.
  • Coordinate with medical and billing teams for smooth pre-authorization and discharge documentation.
  • Documentation & Reporting:
  • Maintain detailed records of empanelment status, claims, and correspondence.
  • Generate periodic reports on empanelment activities, claims performance, and insurer feedback.
  • Ensure compliance with insurance guidelines and regulatory requirements.
  • Relationship Management:
  • Build and maintain strong professional relationships with insurance and TPA representatives.
  • Address queries or grievances from insurers and ensure smooth claim settlements.

Qualifications:

  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field.
  • Minimum 1–2 years of experience in hospital insurance coordination, with hands-on empanelment experience.
  • Strong knowledge of insurance procedures, claim processing, and government health schemes.
  • Familiarity with ICD/CPT coding and medical billing software is a plus.
  • Proficient in MS Office (Excel, Word) and hospital information systems (HIS).
  • Excellent communication, negotiation, and documentation skills.

Job Type: Full-time

Pay: ₹18, ₹22,000.00 per month

Benefits:

  • Health insurance
  • Provident Fund

Work Location: In person

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