🔍 Job Summary:
The Insurance Officer – IP Approval is responsible for reviewing, processing, and securing insurance approvals for inpatient (IP) admissions and procedures. The role ensures accurate documentation, compliance with insurance policies, and timely coordination with healthcare providers, patients, and insurance companies.
🛠 Key Responsibilities:
- Review and verify patient eligibility, coverage, and policy benefits for inpatient services
- Prepare and submit pre-authorization requests to insurance companies
- Ensure proper documentation, clinical justification, and compliance with insurance requirements
- Follow up on pending approvals and resolve discrepancies with insurers
- Communicate approval status, requirements, or denials to physicians, patients, and hospital staff
- Maintain accurate records of approvals, denials, and correspondence
- Support billing teams in claim submission and reimbursement processes
- Stay updated with insurance policies, regulations, and payer requirements
🎓 Requirements:
- Bachelor’s degree in healthcare administration, insurance, or related field (preferred)
- Experience in medical insurance approval, claims processing, or hospital billing
- Knowledge of medical terminology, ICD/CPT coding, and insurance guidelines
- Strong communication and negotiation skills with insurers and providers
- Proficiency in hospital information systems and MS Office
- Attention to detail and ability to manage multiple approvals in a fast-paced environment
- Commitment to accuracy, confidentiality, and regulatory compliance