Insurance Head
1 day ago
Role & responsibilities
- Develop and execute insurance/TPA strategy aligned with hospital growth.
- Drive empanelment with new insurers and negotiate contracts/tariffs.
- Oversee end-to-end operations: pre-authorizations, approvals, claims submission, and reimbursements.
- Reduce claim denials and ensure timely collections.
- Lead and mentor the insurance/TPA team; set KPIs and monitor performance.
- Build and maintain strong relationships with insurance companies, TPAs, and brokers.
- Ensure accurate documentation, compliance with regulations, and audit readiness.
- Monitor financial performance, receivables, and revenue leakage.
- Collaborate with internal teams (billing, finance, operations, IT, clinical) for smooth functioning.
- Enhance patient experience by simplifying insurance processes and communication.
- Leverage technology and MIS tools to improve efficiency and reporting.
Preferred candidate profile
- Bachelors degree in Hospital Administration, Business, Finance, or related field (Masters preferred).
- 8 to 12 years of experience in healthcare insurance/TPA operations, with 35 years in a senior leadership role.
- Strong knowledge of medical billing, insurance processes, pre-authorizations, and policy terms.
- Excellent negotiation, communication, and stakeholder management skills.
- Proficiency in data analysis, MIS reporting, and insurance claim systems.
Interested can reach us at /
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