


#1, Radial Road, Pallikaranai, Chennai – 600 100, Tamil Nadu, India
Key Responsibilities 1. Insurance & TPA Coordination Coordinate with TPAs (Third Party Administrators) and insurance companies for claim processing. Handle cashless approvals, pre-authorizations, and claim submissions. Follow up for approvals, queries, and claim settlements. 2. CGHS Process Management Manage CGHS patient documentation, eligibility verification, and approval process. Ensure compliance with CGHS guidelines and package rates. Prepare and submit CGHS bills and supporting documents. 3. Billing & Documentation Prepare accurate insurance and CGHS bills as per hospital policies. Maintain proper documentation for claims, approvals, and rejections. Handle discrepancies and resubmissions. 4. Patient Coordination Guide patients and attendants regarding insurance and CGHS procedures. Explain billing, approvals, and required documents clearly. 5. Claims Follow-up & Reconciliation Track pending claims and ensure timely settlement. Reconcile payments received from insurance/CGHS. Maintain reports on pending, approved, and rejected claims. 6. Compliance & Audit Ensure adherence to hospital policies, insurance norms, and CGHS regulations. Support internal and external audits. Maintain confidentiality of patient and financial data. Qualifications & Experience Graduate in any discipline (commerce/healthcare management preferred). 2-4 years of experience in hospital insurance/TPA/CGHS processing preferred. Knowledge of medical billing and insurance procedures.