Tpa Coordinator

**Job Title**: TPA Coordinator
**Department**: TPA (Third-Party Administrator)
**Location**: Ashtvinayak Hospital, Rasayani
**Salary**: ₹12,000 to ₹ 20,000 per month

**Job Summary**:
Ashtvinayak Hospital is looking for a dedicated and detail-oriented **TPA Coordinator** to join our team. The TPA Coordinator will be responsible for managing the interaction between the hospital and third-party administrators, ensuring smooth processing of insurance claims, and providing support to patients throughout the insurance verification and claim process. This is a full-time position based at our Rasayani branch.

**Key Responsibilities**:

- **Insurance Verification**: Coordinate with insurance companies and third-party administrators to verify patient insurance details, coverage, and eligibility.
- **Claims Processing**: Handle all aspects of claim processing, including documentation, submission of claims, and follow-up to ensure timely settlement of claims.
- **Patient Assistance**: Assist patients in understanding their insurance coverage and guide them through the pre-authorization process.
- **Data Management**: Maintain accurate records of insurance claims, approvals, and denials. Ensure all relevant documentation is available and updated in the system.
- **Coordination with Hospital Departments**: Collaborate with various hospital departments to gather necessary information for insurance claims and approvals.
- **Pre-Authorization**: Ensure pre-authorization requests are processed for surgeries, procedures, and hospital admissions as per insurance guidelines.
- **Billing Support**: Work closely with the billing department to resolve any discrepancies between hospital charges and insurance reimbursements.
- **Follow-Up**: Follow up with insurance companies regarding pending claims and payment status, ensuring timely resolution.
- **Customer Service**: Provide excellent service to patients and their families, addressing queries regarding insurance-related matters and resolving any issues that may arise.

**Qualifications & Skills**:

- **Education**: Graduate in any stream; a background in healthcare administration or insurance is a plus.
- **Experience**: Prior experience in TPA or insurance coordination in a hospital or healthcare setting is preferred.
- **Skills**:

- Strong communication skills (both verbal and written).
- Good organizational skills with attention to detail.
- Ability to work under pressure and meet deadlines.
- Basic knowledge of health insurance policies, procedures, and claim settlement processes.
- Proficiency in MS Office (Word, Excel) and hospital management software.
- Ability to handle sensitive patient information with confidentiality.

**Additional Requirements**:

- Positive attitude and willingness to work in a team-oriented environment.
- Ability to work flexible hours when necessary, including weekends and holidays.
- Basic understanding of medical terminology is a plus.

**Benefits**:

- Competitive salary of ₹15,000 per month.
- Opportunity to work with a leading hospital in the Rasayani region.
- Learning and development opportunities in the healthcare and insurance sector.

**How to Apply**:
Pay: ₹12,000.00 - ₹20,000.00 per month

Schedule:

- Day shift

Work Location: In person