Insurance Coordinator

JOB DESCRIPTION INSURANCE COORDINATOR

Department: Insurance / Billing
Designation: Insurance Coordinator
Industry: Hospital / Healthcare – MV Hospital for Diabetes
Work Location: MV Hospital for Diabetes, Royapuram, Chennai
Working Hours: 9:00 AM – 6:00 PM
Experience: 2–5years in Hospital Insurance / TPA / Medical Claims

Educational Qualification

• Any Degree / B.Com / BBA / Healthcare Management preferred.
• Certification in Medical Billing, Insurance or Healthcare Administration will be an added advantage.

Key Responsibilities

• Coordinate with patients, doctors, billing team and insurance/TPA companies for claim processing.
• Handle cashless and reimbursement insurance claims from admission to discharge.
• Verify patient insurance eligibility, policy details and coverage.
• Prepare and submit pre-authorisation requests to insurance companies/TPAs.
• Coordinate for approval, enhancement and final authorisation.
• Collect and verify required medical and billing documents for claim submission.
• Prepare and submit discharge claim documents within the required timelines.
• Follow up with insurance companies/TPAs regarding pending approvals and claims.
• Coordinate with the medical records, billing and accounts departments for required documents.
• Track rejected, pending and settled claims and take necessary follow-up action.
• Maintain proper records of insurance claims, approvals and settlements.
• Communicate with patients and their attendants regarding insurance procedures and claim requirements.
• Ensure accurate documentation and timely submission of claims.
• Handle insurance queries and resolve claim-related issues.
• Maintain confidentiality of patient and insurance information.
• Prepare daily/weekly/monthly insurance claim status reports.

Required Skills

• Good knowledge of Hospital Insurance and TPA claim processes.
• Knowledge of cashless and reimbursement procedures.
• Good communication and interpersonal skills.
• Basic knowledge of medical terminology and hospital billing.
• Good computer knowledge, especially MS Excel and MS Office.
• Strong follow-up and coordination skills.
• Ability to work accurately under pressure and meet claim-processing timelines.

Preferred Experience

Experience in:

• Hospital Insurance / TPA Desk
• Cashless Claim Processing
• Pre-authorisation & Final Approval
• Medical Billing
• Insurance Claim Documentation
• Claim Reconciliation and Follow-up

Working Hours

9:00 AM – 6:00 PM

Preferred candidate profile