Corporate Desk - ECHS/CGHS/PSU

Max Healthcare; New Delhi; On-site; INR 600,000 - 800,000; Full time

Job summary

Max Healthcare, Delhi, is seeking a coordinator to manage patients under CGHS, ECHS, PSU and other government or corporate schemes. The role includes verifying eligibility, entitlement, referral letters and health cards, and coordinating patient registration and OPD visits.

You will process pre-authorisation requests, obtain approvals, liaise with TPA and insurance teams for cashless treatment, monitor status, and ensure timely submission of medical documents, estimates and discharge summaries.

Responsibilities

• Handle patients referred under CGHS, ECHS, PSU and other government/corporate healthcare schemes.
• Verify patient eligibility, entitlement, referral letters, health cards and other required documents.
• Coordinate with respective departments for patient registration, OPD consultations and admissions.
• Process pre-authorisation requests and obtain necessary approvals from concerned authorities.
• Coordinate with TPA, government departments, PSU representatives and insurance teams for cashless treatment approvals.
• Ensure timely submission of medical documents, estimates, treatment plans and discharge summaries.
• Monitor approval status, extensions and pending cases to avoid delays in patient treatment.
• Coordinate with billing and accounts teams for final billing, package rates and claim documentation.
• Ensure compliance with CGHS, ECHS and PSU rate contracts, guidelines and hospital policies.
• Maintain records of patient cases, approvals, claims, rejections and pending payments.
• Resolve patient and corporate queries related to scheme eligibility, billing and treatment procedures.
• Follow up on outstanding claims and coordinate for timely settlement.

Job description

Key Responsibilities

1. Handle patients referred under CGHS, ECHS, PSU and other government/corporate healthcare schemes.
2. Verify patient eligibility, entitlement, referral letters, health cards and other required documents.
3. Coordinate with respective departments for patient registration, OPD consultations and admissions.
4. Process pre-authorisation requests and obtain necessary approvals from concerned authorities.
5. Coordinate with TPA, government departments, PSU representatives and insurance teams for cashless treatment approvals.
6. Ensure timely submission of medical documents, estimates, treatment plans and discharge summaries.
7. Monitor approval status, extensions and pending cases to avoid delays in patient treatment.
8. Coordinate with billing and accounts teams for final billing, package rates and claim documentation.
9. Ensure compliance with CGHS, ECHS and PSU rate contracts, guidelines and hospital policies.
10. Maintain records of patient cases, approvals, claims, rejections and pending payments.
11. Resolve patient and corporate queries related to scheme eligibility, billing and treatment procedures.
12. Follow up on outstanding claims and coordinate for timely settlement.