Insurance Executive

Drlogy; Chennai; On-site; INR 300,000 - 600,000; Full time

Job summary

Drlogy in Chennai is seeking an Insurance Executive to oversee insurance operations. The role requires managing pre-authorization, claim submissions, and ensuring compliance with insurance policies. Candidates should have a strong knowledge of insurance procedures, excellent documentation skills, and the ability to handle multiple cases efficiently. You will coordinate with insurance companies, assist in claim settlements, and maintain records. A customer-centric approach is essential for enhancing patient experience and ensuring timely approvals.

Responsibilities

• Oversee end-to-end insurance operations including pre-authorization and claim submission.
• Handle insurance and TPA-related processes for IPD and OPD patients.
• Ensure compliance with insurance policies and hospital protocols.
• Maintain confidentiality of patient and insurance information.

Skills

Strong knowledge of insurance procedures

Documentation accuracy

Ability to handle multiple cases efficiently

Customer-centric approach

Job description

The Insurance Executive will oversee end-to-end insurance operations including pre-authorization, claim submission, and settlement processes. This requires strong knowledge of insurance procedures, documentation accuracy, and the ability to handle multiple cases efficiently.

Roles and Responsibilities:

• Handle insurance and TPA-related processes for IPD and OPD patients.
• Process pre-authorization requests and ensure timely approvals.
• Coordinate with insurance companies and TPAs for claim processing.
• Verify patient insurance details, coverage, and eligibility.
• Ensure accurate and complete documentation for all insurance cases.
• Follow up on pending approvals, queries, and claim settlements.
• Coordinate with billing, front office, and clinical departments for required documents.
• Ensure timely submission of claims and minimize rejections.
• Resolve issues related to insurance claims and patient queries.
• Maintain records of all insurance transactions and documentation.
• Ensure compliance with insurance policies, guidelines, and hospital protocols.
• Assist in reconciliation of claims and payments with accounts team.
• Support audit requirements and ensure insurance records are audit-ready.
• Maintain confidentiality of patient and insurance information.
• Track claim status and provide regular updates to patients and management.
• Coordinate discharge process for cashless patients smoothly.
• entify discrepancies and take corrective actions promptly.
• Maintain updated knowledge of insurance policies and TPA guidelines.
• Ensure proper communication with patients regarding approvals and coverage.
• Work closely with corporate relations and TPA desk for smooth operations.
• Prepare daily and monthly reports related to insurance cases.
• Handle multiple cases efficiently under time constraints.
• Maintain professionalism and customer-centric approach.
• Participate in training programs and process improvement initiatives.
• Contribute to enhancing overall patient experience and revenue cycle efficiency.