Course Overview
The Medical Insurance in Healthcare Sector program by IIRDC–NExora equips learners with essential skills in health insurance operations, TPA coordination, claims processing, medical billing systems, hospital insurance desk work, and digital health insurance platforms.
This program aligns with the NCrF/NHEQF national framework, ensuring academic credit benefits, industry approval, and high employability in the rapidly growing medical insurance sector.
-
Course Modules
Core Subjects
- Introduction to Health Insurance
- Types of Medical Insurance Policies
- Hospital Billing Systems
- TPA Coordination
- Cashless & Reimbursement Processing
- Digital Insurance Platforms
- Medical Documentation
- Healthcare Finance Basics
- ICD/CPT Coding Introduction
- Legal & Ethical Aspects in Insurance
Detailed Course Modules
Module 1: Basics of Medical Insurance
- Indian health insurance ecosystem
- Insurance terminologies
- Role of TPAs & insurance companies
Module 2: Hospital Billing & Claims
- Billing process flow
- Pre-authorization documentation
- Cashless approval
Module 3: Reimbursement Processing
- Required documents
- Error-free claim filing
- Claim denial reasons
Module 4: TPA Desk Operations
- Communication with TPA
- Insurance desk documentation
- Patient counselling
Module 5: Digital Insurance & Healthtech
- Digital health insurance portals
- DigiLocker & e-claims
- E-health card processing
Module 6: Legal & Ethical Responsibilities
- IRDAI guidelines
- Hospital insurance compliance
- Ethical claim handling
Show More
Learning Outcome
Students completing this course will learn to:
-
Understand health insurance processes end-to-end
-
Handle cashless & reimbursement claims
-
Coordinate efficiently with TPAs
-
Manage billing and documentation
-
Assist patients with insurance queries
-
Use digital insurance platforms
-
Ensure compliance with IRDAI guidelines
Career Growth
- Senior TPA Executive
- Claims Manager
- Health Insurance Officer
- Hospital Billing Manager
- Medical Finance Coordinator
- Insurance Corporate Trainer
- Healthcare Finance Manager
Placement opportunities
Job Roles
- TPA Coordinator
- Medical Insurance Executive
- Hospital Billing Staff
- Claims Processing Officer
- Patient Insurance Counsellor
- Reimbursement Assistant
- Health Insurance Analyst
- Hospital Finance Support Staff
Industries Hiring
- ✔ Multi-specialty Hospitals
- ✔ Insurance Companies
- ✔ TPAs
- ✔ Diagnostic Centres
- ✔ Healthcare Corporates
- ✔ Medical Billing Agencies
- ✔ Telehealth Insurance Portals