Tpa Coordinator
3 months ago
**Job Title**: TPA Billing Staff
**Location**: Surya Hospital
**Department**: Billing/TPA
**Reports to**: Billing Manager/TPA Coordinator
**Job Summary**:
The TPA Billing Staff is responsible for handling all third-party administrator (TPA) billing-related processes, ensuring accurate and timely processing of patient claims, and coordinating with TPAs, insurance companies, and the internal finance team. The role involves managing claims, settlements, documentation, and ensuring compliance with hospital billing protocols.
**Key Responsibilities**:
- **TPA Claims Processing**: Manage TPA claims for insured patients, ensuring that all necessary documentation is completed and submitted on time.
- **Billing Management**: Ensure accurate billing based on hospital services provided, review patient records, and align them with TPA billing standards.
- **Coordination with TPAs**: Liaise with TPA representatives and insurance companies to resolve any discrepancies, missing documents, or approvals required.
- **Follow-up on Approvals**: Continuously follow up with TPAs to obtain necessary approvals for patient treatment, surgeries, and other medical procedures.
- **Handling Reimbursements**: Ensure timely processing of claims, settlements, and reimbursements from TPAs and insurance companies.
- **Patient Communication**: Communicate with patients to inform them of the TPA process, any documentation required, and update them on the claim status.
- **Maintain Billing Records**: Keep accurate records of all patient billing, including charges, payments received, and pending claims.
- **Compliance & Audit**: Ensure compliance with hospital billing policies, TPA guidelines, and provide necessary documentation during internal or external audits.
- **Reporting**: Prepare and present regular reports on pending and settled claims to the Billing Manager.
**Qualifications**:
- Bachelor’s degree in commerce, finance, or a related field.
- **Experience**: Minimum 2-3 years of experience in hospital billing and TPA processing.
- **Technical Skills**: Proficiency in hospital billing software and knowledge of insurance claim processing.
- Strong understanding of TPA procedures, hospital billing practices, and medical terminology.
- **Excellent communication and coordination skills.**
Pay: ₹25,000.00 - ₹35,000.00 per month
Schedule:
- Day shift
**Experience**:
- total work: 3 years (preferred)
Work Location: In person
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