Senior Executive

Niva Bupa Health Insurance Company Limited; Mumbai; On-site; INR 500,000 - 700,000; Full time

Job summary

Nivabupa is seeking a dedicated Insurance Claim Facilitator to manage seamless claim facilitation for hospitalized patients in Mumbai. You will focus on cost management, enhance customer experience, and coordinate with TPAs, insurers, and providers to optimize treatment packages and expedite approvals.

The role emphasizes hassle-free admission and discharge, strong relationship-building with providers, and reducing query rates while ensuring efficient claim processing.

Qualifications

• Experience in hospital operations or TPA/insurance is preferred.
• Strong communication and follow-up skills are essential.
• Sales orientation with customer engagement skills is beneficial.

Responsibilities

• Customer Experience: Hand Hold Patient during Hospital Journey.
• Improve trust and reduce anxiety through facilitation for insured individuals.
• Reduce insured escalations to streamline process.
• Speed: Improve pre-authorization and discharge turnaround time (TAT).

Skills

Hospital operations

Health insurance

TPAs

Hospital billing

Customer relationships

Education

Graduate

Masters or Diploma in Healthcare administration

Job description

Job Summary

Job Summary: The person would be responsible for seamless insurance claim facilitation forhospitalized patients while ensuring effective cost management as well.

The role focuses on enhancing customer experience, enabling hassle free admission and discharge,coordinating with TPAs, insurer, providers and optimizing treatment and packages, faster claimapprovals and reduce query rates.

Key Responsibilities

• 1. Customer Experience: Hand Hold Patient during Hospital Journey
• 2. Customer: Improve trust and reduce anxiety through facilitation
• 3. Reduce Insured Escalations
• 4. Speed: Improve Pre-auth and Discharge TAT
• 6. Provider Engagement: Strengthen PPN/NPPN relationships

Key Requirements –

Education & Certificates

• 1. Graduate
• 2. Masters or Diploma in Healthcare administration
• 3. 2-4 years Experience of working in Hospital operations or TPA/ Insurance.

Key Requirements -

Experience & Skills (Must have)

• 1. Strong understanding of Hospitals operations, health insurance, TPAs and hospital billing
• 2. Ability to build trust and customer relationships
• 3. Excellent communication and follow up skills
• 4. Sales orientation with customer engagement skills
• 5. Analytical mindset and long-term relationships.