: Cashless Insurance Claim Executive (Hospital) (Kolhapur)

Job Description: Cashless Insurance Claim Executive (Hospital) Position Title: Cashless Insurance Claim Executive Department: TPA / Insurance Department Location: Jaya Urology Hospital & Nursing Home. Reports To: Operations Head Job Summary The Cashless Insurance Claim Executive is responsible for managing cashless and reimbursement insurance claim processes within the hospital. The role involves coordinating with insurance companies and TPAs, handling patient insurance documentation, obtaining approvals, and ensuring timely claim submission and settlement. The candidate should possess strong knowledge of hospital insurance procedures, excellent communication skills, and positive computer proficiency. Key Responsibilities
- Handle end-to-end cashless hospitalization claim processes.
- Coordinate with insurance companies and TPAs for pre-authorization approvals and claim settlements.
- Verify patient insurance eligibility, policy coverage, and required documentation.
- Collect, prepare, and submit all necessary claim documents accurately and within timelines.
- Manage reimbursement claim documentation and submission processes.
- Follow up with insurance companies/TPAs for pending approvals, deficiencies, and claim settlements.
- Maintain proper records of claims, approvals, denials, and payment status.
- Coordinate with doctors, billing department, nursing staff, and patients for required medical and billing documents.
- Guide patients and attendants regarding insurance procedures and required formalities.
- Ensure compliance with hospital protocols and insurance guidelines.
- Resolve claim-related queries and escalations professionally.
- Prepare daily/monthly MIS reports related to insurance claims and settlements. Required Qualifications
- Graduate in any discipline. (B. Com preferred)
- Certification or training in medical insurance/TPA processes is an added advantage. Experience
- 0–3 years of experience in hospital insurance claims, TPA coordination, or medical billing preferred.
- Experience handling cashless and reimbursement claims in a hospital setup is preferred. Required Skills
- Good knowledge of hospital insurance and TPA processes.
- Familiarity with cashless claim approvals and reimbursement procedures.
- Good computer knowledge including MS Office, Hospital Management Systems (HMS), and email communication.
- Strong communication and coordination skills.
- Positive documentation and record management abilities.
- Ability to work under pressure and handle multiple claims simultaneously. Key Competencies
- Attention to Detail
- Patient Handling Skills
- Follow-up & Coordination
- Problem Solving
- Time Management
- Team Collaboration Working Conditions
- Hospital-based working environment.
- May require rotational shifts depending on hospital operations. Salary
- As per industry standards and candidate experience. Pay: ₹12,276.82
- ₹14,000.00 per month Benefits:
- Provident Fund Work Location: In person Apply on Kit Job: kitjob.in/job/4mra88