Insurance Coordinator

4 days ago

Chennai, Tamil Nadu, India MIOT International Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Department: Insurance

Reports To: HOD Insurance

Job Summary:

The Insurance Coordinator is responsible for managing all aspects of patient insurance processes, including verification, preauthorization, documentation, claims submission, and follow-up. The role ensures smooth coordination between patients, insurance companies, and hospital departments to facilitate timely and accurate claim settlements.

Key Responsibilities:

  1. Insurance Verification & Preauthorization:

  2. Verify patients insurance coverage, eligibility, and policy details before admission or treatment.

  3. Obtain preauthorization from insurance providers for procedures, surgeries, and inpatient admissions.

  4. Documentation & Coordination:

  5. Ensure all required patient and clinical documents are complete and accurately submitted to the insurer.

  6. Liaise with consultants, doctors, and billing departments for clarification and supporting documents.

  7. Claims Management:

  8. Prepare and submit insurance claims within the specified timelines.

  9. Track claim status and follow up with insurance companies to resolve pending or denied claims.

  10. Patient Communication:

  11. Explain insurance processes, coverage limits, and exclusions to patients and their families.

  12. Assist patients with queries regarding insurance approvals and claim settlements.

  13. Compliance & Reporting:

  14. Maintain accurate records of insurance correspondence and claim logs.

  15. Ensure compliance with hospital policies, TPA (Third-Party Administrator), and regulatory requirements.
  16. Generate daily, weekly, and monthly insurance reports for management review.

Qualifications & Skills:

  • Bachelors degree in Hospital Administration, Commerce, or related field.
  • 1 to 3 years of experience in hospital insurance or billing department preferred.
  • Good knowledge of health insurance procedures, TPAs, and claim documentation.
  • Strong communication and coordination skills.

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