Insurance Manager

We are looking for an experienced Insurance & TPA Executive to manage all insurance-related activities for our hospital/clinic.

Key Responsibilities:

• Handle insurance company and TPA empanelment processes from start to finish.

• Prepare and submit applications for empanelment with insurance companies and TPAs.

• Coordinate for NABH, ROHINI and other compliance-related documentation required for empanelment.

• Follow up regularly with insurance companies, TPAs and hospital networks.

• Negotiate procedure packages and tariffs with insurance providers.

• Manage pre-authorizations, approvals, queries and claim submissions.

• Coordinate with doctors, billing department and patients regarding insurance approvals.

• Track claim status and ensure timely settlement of claims.

• Maintain empanelment records, agreements and renewal schedules.

• Develop relationships with insurance companies, TPAs and corporate organizations.

• Identify new empanelment opportunities and expand hospital cashless network coverage.

• Generate periodic reports regarding approvals, claims and empanelment status.

Requirements:

• Experience in hospital insurance, TPA coordination or medical billing preferred.

• Knowledge of cashless insurance processes, pre-authorizations and claim management.

• Experience in insurance empanelment and package negotiations preferred.

• Good communication, documentation and follow-up skills.

• Ability to work independently and coordinate with multiple stakeholders.

Salary: Negotiable based on experience + Performance Incentives.

Interested candidates may apply with their updated resume.

“Experience in insurance empanelment and package negotiation is mandatory.”