Tpa Executive

4 weeks ago

Ahmedabad, India Narayana Health (NH) Full time

Job Summary

To register new patients under TPA, attend queries, pre-authorization of request, claims, bill recovery.

Job Responsibilities

  • Handling all debtor receivables,
  • Solving all queries, which are related to bill.
  • Checking all IP files before dispatch.
  • Checking the reasons of cancellation of bill, free bill, discount bill, refund bill.
  • Preauthorization request will be sent to the respective scheme office for the approval of the concerned treatment (surgical / medical)
  • Making the changes of packages rates/tests rates as per the Company Agreement.
  • Maintaining the Debtors aging report for OP & IP
  • All the inpatient bills will be sent for the claims to the respective scheme office.
  • Communication with the doctors for any techno-medical clarifications of any query by the TPAs, companies.
  • Communicate with the TPA customer care for details of the bill.
  • Communicate with the companies and TPA's for follow-up on the payments of bills.
  • Bills recovery.
  • Interaction with the patients for payments of the dues, which are not made by the TPA or company.
  • Check the bottlenecks that arise in the payments and solve the problems regarding the bills
  • Responsible for related to high-value payments to reduce the company's outstanding liabilities.

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