Insurance Coordinator
7 days ago
Job Title: Pre-Authorization Executive – Health Insurance Claims
Location: Chennai
Experience: 0.6–2 years
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.
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