Tpa Coordinator

7 days ago


Shahpura Bhopal Madhya Pradesh, India Bansal News Full time

**Hiring For Bansal Hospital Bhopal**

**Location_ Bhopal (On-site)**

**Profile _TPA Manager**

Looking for third-party administrator (TPA) who **provides administrative services for self-funded health plans, sometimes referred to as self-insured health plans, in the health insurance industry**.

**Responsibilities**

Coordinating all activities related to patient claims and insurance.

Supervise the process of filing and tracking insurance claims for patients, ensuring claims are submitted timely and correctly.

Ensure regular follow-up on pending or rejected claims and coordinate with TPAs for resubmission or dispute resolution.

Assist patients in understanding their insurance coverage, including what services are covered, co-payments, and out-of-pocket expenses.

Ensure that all claims processes are compliant with hospital policies, TPA agreements, and insurance regulations.

Collaborate with various hospital departments (billing, finance, medical, etc.) to ensure accurate documentation for claims and smooth processing of patient records.

Monitor and track the status of submitted claims, pending approvals, and settlements, ensuring that TPA services meet performance benchmarks.

Coordinate with hospital billing departments for adjustments in patient bills based on insurance approvals and coverage terms.

**Skills Required**:
Knowledge of Health Insurance and TPA Processes.

Communication and Interpersonal Skills.

Technical Skills and Software Proficiency.

Regulatory and Compliance Knowledge.

Risk and Fraud Management.

Schedule:

- Day shift

**Experience**:

- Mediclaims: 5 years (required)

Work Location: In person


  • Tpa Billing Executive

    3 months ago


    Noida, Uttar Pradesh, India Motherland Hospital Full time

    TPA Executive ( 1 to 6 years of experience) graduate **Job description** **Job Purpose**: Responsible for managing and reconciling payments related to executive compensation within the organization. This role requires meticulous attention to detail, strong analytical skills, and the ability to collaborate effectively with various departments to ensure...

  • Tpa Executive

    4 months ago


    Amkhoh, Gwalior, Madhya Pradesh, India PARIVAR SUPER SPECIALTY HOSPITAL AND RESEARCH CENTRE Full time

    1. Post Sales Service 2. Coordination with Corporate, Brokers & Insurance Companies 3. Follow ups 4. Preparation of Reports 5. Broker & Client Servicing 6. Coordination with all departments for claim processing **Salary**: ₹15,000.00 - ₹20,000.00 per month Schedule: - Night shift - Rotational shift **Experience**: - total work: 1 year...

  • Tpa Coordinator

    4 months ago


    Varanasi, Uttar Pradesh, India Shree Hr services Full time

    Must have knowledge on Medical insurance terms & conditions. Able to work independently. Key Skills Medical insurance claims, Basic computer knowledge. Required Experience and Qualifications Minimum 1 year experience in any medical form or hospital. **Salary**: ₹14,000.00 - ₹20,000.00 per month **Benefits**: - Provident Fund Schedule: - Day...

  • Aayushman Executive

    4 months ago


    Sikandar, Agra, Uttar Pradesh, India UJALA CYGNUS RAINBOW HOSPITAL, AGRA Full time

    1. Your duty hours shall be from 10.00am to 07.00pm. 2. To ensure increasing revenue of the Hospital by increasing numbers of patients in the hospital and increasing third party paying customers of the hospital. 3. To handling all departments of IPD Billing, Credit Patient Dept. (Aayushman ) dispatch & recovery. 4. To establish contacts with corporations,...


  • Noida H.O , Noida, Uttar Pradesh, India Immabeme Solutions Pvt Ltd Full time

    Key Responsibilities: Patient Documentation: Manage patient medical history and progress notes with precision. Claims Processing: Handle pre authorization and reimbursement claims, including validation and processing. Clinical Records: Maintain accurate clinical documentation in compliance with healthcare standards. Collaboration: Work closely with...


  • Noida, Uttar Pradesh, India MedCare Solutions Full time

    Pay: From ₹15,000.00 per month Schedule: - Day shift Supplemental Pay: - Overtime pay Work Location: In person


  • Noida, Uttar Pradesh, India MedCare Solutions Full time

    Pay: From ₹18,000.00 per month Schedule: - Day shift Supplemental pay types: - Overtime pay Work Location: In person


  • Bhopal, India Rentokil Initial Full time

    ABOUT US:Rentokil PCI brings to the Indian market the expertise of over 90 years of Rentokil, the world's largest commercial pest control company with operations in more than 70 countries and PCI, the number one pest control company in India with presence in the local market for over 60 years.Rentokil PCI aims to set new standards for customer service with...


  • Andhra Pradesh, India Aditya Birla Group Full time

    **Designation**:Senior Engineer - Mechanical **Updated**:October 01, 2024 **Location**:Andhra Pradesh, India **Organization**:Metals **Job Purpose**: Responsible for execution of identified Mechanical services and give necessary inputs and guidance to various Utility team regarding Mechanical equipment's and systems that is being erected so that seamless...


  • uttar pradesh, India Navvyasa Consulting Full time

    Key Roles & Responsibilities:Grievance Management: - Oversee and manage the entire grievance process, ensuring timely resolution of customercomplaints and grievances related to health insurance policies. - Ensure adherence to regulatory guidelines and company policies for grievance redressal. - Implement and monitor grievance handling procedures to ensure...


  • uttar pradesh, India Navvyasa Consulting Full time

    Key Roles & Responsibilities: Grievance Management: • Oversee and manage the entire grievance process, ensuring timely resolution of customer complaints and grievances related to health insurance policies. • Ensure adherence to regulatory guidelines and company policies for grievance redressal. • Implement and monitor grievance handling procedures to...

  • Medical Trainer

    3 months ago


    Varanasi, Uttar Pradesh, India Writer Information Full time

    **Position: Medical Trainer** **Education: MBBS is must** **Exp - 0-2 years** **TRAVEL IS MUST!** CTC- Upto 4.8lpa **Key Responsibilities**: - Train District Coordinators (DCs) and Pradhan Mantri Arogya Mitras (PMAMs) on various medical packages. - Track and resolve queries from hospitals. - Coordinate with Third Party Administrators (TPAs) and...

  • Intensivist Mbbs

    4 months ago


    Noida, Uttar Pradesh, India Immabeme Solutions Pvt Ltd Full time

    Job description of Intensivist: .Verify required documents for claims processing and initiate information requests in case of insufficiency. - Conduct tele rounds, including patient reviews, daily rounds, and reviews of labs, radiology, and drug charts. - Actively liaise with the bedside team, providing real-time critical care expertise. - Document...

  • Front Office Executive

    4 months ago


    Shivpur, Varanasi, Uttar Pradesh, India Octavia Hospital Full time

    **Purpose of position**: Being the first point of contact of the patient with the hospital, the front office is a very important department for successful running of the hospital. The main purpose of the front office staff is patient registration and information management. **Duties and responsibilities**: **Following activities to be performed at front...

  • General Physician

    4 months ago


    Noida, Uttar Pradesh, India VISIT Health Private Limited Full time

    _**About Visit**:_ Visit App is a 360° integrated, full stack & highly engaging Health Benefits Platform that holistically covers preventive to curative care ranging across: - Daily Health Goals Management & Wellness(Step Tracking, Sleep Tracking, Calorie Counter, Risk Profiling etc.) Live/Recorded Sessions, Nutrition & Rewards Program - EAP Program -...

  • General Physician

    4 weeks ago


    Noida, Uttar Pradesh, India VISIT Health Private Limited Full time

    _**About Visit**:_ Visit App is a 360° integrated, full stack & highly engaging Health Benefits Platform that holistically covers preventive to curative care ranging across: - Daily Health Goals Management & Wellness(Step Tracking, Sleep Tracking, Calorie Counter, Risk Profiling etc.) Live/Recorded Sessions, Nutrition & Rewards Program - EAP Program -...

  • General Physician

    4 weeks ago


    Noida, Uttar Pradesh, India VISIT Health Private Limited Full time

    _**About Visit**:_ Visit App is a 360° integrated, full stack & highly engaging Health Benefits Platform that holistically covers preventive to curative care ranging across: - Daily Health Goals Management & Wellness(Step Tracking, Sleep Tracking, Calorie Counter, Risk Profiling etc.) Live/Recorded Sessions, Nutrition & Rewards Program - EAP Program -...


  • uttar pradesh, India Navvyasa Consulting Full time

    Key Roles & Responsibilities:Grievance Management:• Oversee and manage the entire grievance process, ensuring timely resolution of customercomplaints and grievances related to health insurance policies.• Ensure adherence to regulatory guidelines and company policies for grievance redressal.• Implement and monitor grievance handling procedures to ensure...

  • Doctor

    4 months ago


    Lucknow, Uttar Pradesh, India Writer Information Full time

    **PREVIOUS EXPERIENCE IN AYUSHMAN BHARAT YOJNA IS MUST** **Key responsibilities**: - MEDICO Person will help in training DCs and PMAM on different Medical Packages. - Help in tracking and resolving the queries of Hospitals. - Coordinate with TPA/ ISA ensuring claims approval of Hospitals as we will be getting paid only from the claims Paid amount of the...

  • Medical Trainer

    4 months ago


    Noida, Uttar Pradesh, India Writer Information Full time

    **Job Title: Medical Trainer** **Key Responsibilities**: 1. Conduct training sessions for District Coordinators (DCs) and Program Medical Assistance Managers (PMAMs) on various medical packages. 2. Assist in tracking and resolving queries from hospitals regarding medical packages. 3. Coordinate with Third Party Administrators (TPAs) or Insurance Service...