Insurance Executive

Drlogy; Amritsar; On-site; INR 300,000 - 450,000; Full time

Job summary

Drlogy is seeking an Insurance Executive to enhance the hospital’s revenue cycle. This role focuses on managing insurance documentation, processing claims, and coordinating with patients and insurance providers. Candidates should have a strong knowledge of healthcare insurance processes, attention to detail, and excellent communication skills. Responsibilities include handling insurance claims from pre-authorization to settlements, ensuring compliance with guidelines, and improving revenue efficiency.

Qualifications

• Strong knowledge of healthcare insurance processes.
• Attention to detail and effective communication skills.

Responsibilities

• Handle end-to-end insurance processes including approvals and claim settlements.
• Verify patient insurance eligibility and coverage details.
• Prepare, review, and submit accurate claim documents.

Job description

The Insurance Executive will play a key in the hospital’s revenue cycle by handling insurance documentation, processing claims, and coordinating with patients and insurance providers. This requires strong knowledge of healthcare insurance processes, attention to detail, and effective communication skills.

Roles and Responsibilities:

• Handle end-to-end insurance and TPA processes including pre-authorization, approvals, and claim settlements.
• Verify patient insurance eligibility, coverage details, and policy limits.
• Coordinate with insurance companies and TPAs for cashless approvals and claim processing.
• Prepare, review, and submit accurate claim documents in a timely manner.
• Follow up on pending claims, approvals, and reimbursements.
• Manage claim rejections, denials, and resubmissions effectively.
• Coordinate with doctors, nursing staff, and billing teams for required medical documentation.
• Assist patients and attendants in understanding insurance policies and claim procedures.
• Ensure proper documentation and maintenance of patient insurance records.
• Support discharge processes by ensuring timely insurance approvals and billing clearance.
• Maintain accurate records of claims, approvals, and outstanding cases.
• Ensure compliance with insurance guidelines, hospital policies, and regulatory requirements.
• Liaise with corporate clients and insurance representatives for smooth operations.
• Handle escalations and resolve insurance-related issues promptly.
• Prepare reports related to claims, approvals, and collections.
• Ensure confidentiality and security of patient and financial data.
• Participate in audits and ensure documentation readiness.
• Stay updated with changes in insurance policies, TPA processes, and regulations.
• Coordinate with finance and billing teams to improve revenue cycle efficiency.
• Maintain professionalism, accuracy, and attention to detail in all tasks.
• Contribute to improving patient experience and financial workflow efficiency.