Claims Cordineter - Jupiter Lifeline Hospital, Pvt Ltd Baner Pune - Pune
(2026-01)
In a Hospital in TPA (Third Party Administrator) department mainly handles health insurance processing and coordination between patients, insurance companies, and the Hospital.
- Verify patient insurance details at admission
- Check policy coverage, eligibility, and exclusions
- Coordinate with insurance companies / TPAs for approvals
- Prepare and submit pre-authorization (cashless approval) requests
- Handle claim documentation and billing
- Track claim status and follow up for approvals or payments
- Explain insurance coverage and liabilities to patients
- Knowledge of medical insurance policies
- Understanding of hospital billing and medical terminology
- Good communication skills
- Computer knowledge (HIS software, MS Excel)
- Prepare final bill as per insurance guidelines
- Ensure documents are complete (discharge summary, investigation reports, prescriptions)
- Submit claims to TPA/insurance portal
Senior Executive – Claims - Star Health Insurance Company Pvt. Ltd.
(2016-11 - 2025-09)
- Handling cashless claims with first-level scrutiny & approvals
- Coordinated with hospital TPAs for claims-related escalations and resolved issues
- Maintained daily Excel MIS sheets for claims tracking and reporting
- Handling reimbursement claims from multiple branches, agents, and customers
- Escalation management for rejections, deduction reconsiderations from agents, SMs, BMs, and customers
- Supporting DMS team for uploading claims documents
- Provided detailed explanations of claim decisions to stakeholders
Billing Executive - Jehangir Hospital, Pune - Pune
(2016-11 - 2025-09)
- Preparing In Patient billing, accounts reconciliation, and claim submissions
- Co ordinated with insurance desk for pre-authorizations and claims settlements
- Handling customer queries and resolve the issues related to billing, insurance and support for smooth processing
- Preparing estimation for cash and insurance customer
Billing Executive - NIO Hospital, Shivajinagar, Pune - Pune
(2013-01 - 2013-03)
- PREPARING ESTIMATION FOR CASH AND INSURANCE CUSTOMER
- PREPARING IN PATIENT AND OPD BILLING FOR CASH AND INSURANCE CUSTOMER
- CO ORDINATE WITH INSURANCE COMPANIES FOR PRE AUTHORISATION AND CLAIMS SETTLEMENT
- HANDLING CUSTOMER QUERIES AND RESOLVE THE ISSUES RELATED TO BILLING, INSURANCE AND SUPPORT FOR SMOOTH PROCESSING
Billing Executive - Sahyadri Super Speciality Hospitals Pvt. Ltd., Hadapsar - Hadapsar
(2012-01 - 2012-03)
- Preparing In patient and OPD billing for Cash and Insurance customer
- Co ordinate with Insurance companies for Pre authorisation and claims settlement
- Handling customer queries and resolve the issues related to billing, insurance and support for smooth processing
- Preparing estimation for cash and insurance customer
Front Office Executive - Inlaks and Budhrani Hospital, Pune - Pune
(2008-05 - 2011-05)
- WORKING AS FRONT OFFICE EXECUTIVE IN ADMISSION DESK FOR IN PATIENT ADMISSION
- HANDLING OPD CASH COUNTERS AND SIDE BY SIDE IPD BILLING AFTER CLOSING BILLING COUNTER
Billing Person - SHRIMANT MALOJIRAJE RAJE SAHIB SILVER JUBILEE HOSPITAL, PHALTAN - Phaltan
(2000 - 2004)
- PREPARING IPD AND OPD BILLING AND HANDLING CASH AND EMPLOYEES SALARY
- HANDLING THE ACCOUNTS AND PREPARING MONTHLY REPORT TO TRUSTEE'S
- ARRANGE THE TRUSTEES MEETING AND OTHERS DOCUMENTATIONAL WORK
- HANDLING DAY TODAY CASH AND ADMINISTRATION
Administrator - SHREE SADGURU UPLEKAR MAHARAJ MANDIR DEVASTHAN TRUST
(2006-01 - 2006-06)
- HANDLING DAY TODAY CASH AND ADMINISTRATION
- PREPARING DAY TODAY BILLING AND HANDLING CASH AND EMPLOYEES SALARY
- COUNTING DAILY COLLECTION AND DEPOSIT THE CASH IN BANK
Billing & Accounts Assistant - ARVIND CLOTH EMPORIUM
- PREPARING DAY TODAY BILLING AND HANDLING CASH AND EMPLOYEES SALARY
- COUNTING DAILY COLLECTION AND DEPOSIT THE CASH IN BANK
