01Key Responsibilities
Coordinate with insurance companies and TPAs for pre-authorization approvals.
Verify patient eligibility and insurance coverage prior to admission.
Collect and submit necessary documents for pre-authorization and final claims.
Ensure correct coding (ICD, procedure codes) and documentation for claim processing.
Maintain communication between patients, doctors, and insurance desks for status updates.
Track and follow up on pending claims, rejections, or queries.
Prepare and maintain daily insurance MIS reports.
Assist in billing and discharge processes for insured patients.
Support cashless and reimbursement claim procedures.
Ensure compliance with hospital and insurance policies at all times.
Qualifications & Skills:
For Freshers:
Bachelors degree in any discipline (preferably in commerce, healthcare management, or related fields).
Good communication and interpersonal skills.
Basic knowledge of MS Office (Word, Excel).
Eagerness to learn hospital insurance processes.
For Experienced Candidates:
13 years of experience in hospital insurance desk operations or TPA coordination.
Familiarity with pre-authorization, claim submission, and insurance software portals.
Strong follow-up and documentation skills.
Knowledge of TPA networks and corporate insurance policies.
Key Competencies:
Attention to detail
Customer service orientation
Team coordination
Time management
Problem-solving attitude .
