Tpa Coordinator

3 weeks ago


Rewari, India Women Pride Hospital & IVF Full time

**Job Title**: TPA and Ayushman Coordinator

**Experience Required (Minimum 02 Years)**

**Location**: Women Pride Hospital & IVF, Suncity, Rewari

**Key Responsibilities**:

- Manage the end-to-end process of TPA and AB-PMJAY claims submission, verification, and adjudication.
- Serve as the primary point of contact for TPA and AB-PMJAY beneficiaries, addressing inquiries, concerns, and requests for assistance.
- Build and maintain positive relationships with healthcare providers participating in TPA and AB-PMJAY networks.
- Ensure compliance with all regulatory requirements and organizational policies related to TPA and AB-PMJAY claims processing.
- Conduct regular audits of TPA and AB-PMJAY claims data and documentation to identify errors and discrepancies.
- Provide training and support to team members on TPA and AB-PMJAY processes, guidelines, and software systems.
- Prepare reports on TPA and AB-PMJAY claims performance, analyzing key metrics and identifying opportunities for improvement.
- Deliver exceptional customer service to TPA and AB-PMJAY beneficiaries, providers, and stakeholders.

**Qualifications**:

- Minimum of 02 years of experience in a similar role, with specific experience in TPA and AB-PMJAY coordination.
- Proficiency in TPA and AB-PMJAY claims processing software and systems.
- Strong communication, interpersonal, and negotiation skills.
- Detail-oriented approach with a focus on accuracy and compliance.
- Certification or training in healthcare compliance, claims management, or related areas (preferred).

**Salary**: ₹10,000.00 - ₹25,000.00 per month

**Benefits**:

- Health insurance
- Provident Fund

Schedule:

- Day shift
- Night shift
- Rotational shift

Supplemental pay types:

- Performance bonus

Work Location: In person

**Speak with the employer**

+91 8287317740



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