AGM/DGM (Health Insurance Administration & Receivables) Sales and Marketing

Role Overview

The Candidate will be responsible for overseeing and monitoring end-to-end health insurance / TPA process & credit sales & Collection channel across Max Healthcare.

Key Roles and Responsibilities:

• Responsible for TPA / Insurance Empanelment & renewals of contracts.
• Responsible for periodical tariff revision & price negotiation with private & GIPSA insurance companies.
• Responsible for timely recoveries of TPA Credit sales. (Collection & Deduction Recovery)
• Liaoning with TPAs & Insurer key persons and relationship building.
• Responsible for Rejection & Deduction follow ups.
• Responsible for account reconciliation with internal & external customers.
• Regular record updating of Insurance & Deduction Tracker
• Periodic review of individual and departmental performance.
• Defining the organizational goals, strategies, setting of internal monthly targets for collection & deductions.
• Monitor, administer & training of the centralize team.
• Regular visits & meeting with internal customers of the group such as TPA Desk, Finance & Accounts, Front Office, and Bill Dispatch Departments; ensuring smooth functioning of the TPA Process.
• Performing troubleshooting during cashless approvals and pre & post-discharge of the patients for all units
• Ensuring group’s timely dispatch of credit invoices for payment recoveries
• Reconciling accounts with all TPAs, Insurance Companies, and internal Finance Teams
• Directing on-account (NEFT) settlement for ensuring timely settlement of NEFT payments, creating departmental MIS, reports, and presentations pertaining to TPA revenue, debtors aging, collection, deduction, old payment & NEFT (on-account) settlement for periodic review of team with higher management
• Following-up for deduction and rejection of the TPA claims; reviewing & analysing Debtor Ageing and Daily Collection Reports
• Monitoring day to day work of team on receivable software i.e., Eprapti.
• To define and set the centralized TPA process.
• Motivating the team and responsible for high team morale.

Experience & Qualifications:

• Graduate, preferably with an MBA in Marketing or a Diploma in Marketing.
• Preferably with 6 to 10 years of experience in healthcare of handling TPA / Insurance channel.
• Strong Interpersonal skills and conflict resolution ability
• Extremely strong Networking Skills
• Good Organization and Planning Skills
• Strong Relationship Management Skills
• Strong focus on performance and Service Excellence