Manager – Insurance - at a Hospital
Refining Skills Academy
- Chikkaballapur, Karnataka
- Permanent
- Full-time
- Manage and oversee insurance processes, including cashless treatment approvals and reimbursements.
- Work closely with TPAs, insurance companies, and government healthcare schemes (Ayushman Bharat, ESI, CGHS, etc.) for claim settlements.
- Ensure accurate billing and documentation for insured patients.
- Monitor and track claim submissions, approvals, and rejections, ensuring quick resolution of disputes.
- Train hospital staff and doctors on insurance policies, procedures, and medical coding compliance.
- Handle pre-authorization requests and ensure timely processing of insurance approvals.
- Maintain strict compliance with IRDAI regulations and hospital accreditation guidelines.
- Identify and resolve insurance claim discrepancies, delays, or denials.
- Develop and maintain strong relationships with insurers, TPAs, and government agencies.
- Implement fraud detection measures to prevent false claims and misuse of insurance benefits.
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