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Tpa Executive

3 months ago

Thaltej Ahmedabad Gujarat, India Zydus Hospitals Healthcare Research Full time

**Roles and Responsibilities**
- Ensure accuracy in Pre Authorization and Patient History document before the former is send to TPA.
- Communicate to the CC Manager about any possible denials before the patient is admitted by monitoring the recorded preauthorization or History sheet.
- Proactively follow up on enhancements and ensure that the approval is received before the patients time of discharge.
- Monitor the outstanding amount for the patient against the approved packages and inform CC manager about possible payments which the patient has to make.
- Ensure that the bills are complete and according the package.
- Ensure discharges for credit patients are done within 4 hours by coordinating with the ward managers.
- Ensure that the files are sent to Insurance Company as per the defined TAT.
- Keep a good relationship with the TPA’s and Corporates.
- Ensure accuracy of bills sent to corporates and that they are having the necessary Codes and rates with all supporting documents, thereby reducing disallowances.
- Keep track of the bills send for payments and ensure that they are send within 7 days of discharge.
- Role:_Customer Service
- Salary:_ Not Disclosed by Recruiter
- Industry:_Medical Services / Hospital
- Department:_Customer Success, Service & Operations
- Role Category:_Customer Success, Service & Operations - Other
- Employment Type:_Full Time, Permanent
- Key Skills
- Mediclaimtpacashless
- insuranceHealth Insurance
- Skills highlighted with ‘‘ are preferred keyskills

Education
- UG:_Any Graduate

**Company Profile**:
Zydus Hospitals & Healhcare Research Pvt Ltd., Ahmedabad

Zydus Hospitals is a 550 bed super specialty medical institution spanning 16 floors and 2 basement floors. This world class and highly sophisticated hospital offers all major medical specialities, subspecialities, investigation & diagnostics facilities, rehabilitation & physical therapy care, under one roof. The hospitals design ensures higher energy efficiency by allowing greater permeation of sunlight throughout the day and harnessing solar energy for hot water provisioning throughout the hospital complex.
- Company Info
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View Contact Details+
- Contact Company:_Zydus Hospitals & Healhcare Research Pvt Ltd., Ahmedabad
- Address:_Zydus Hospitals Road, Sarkhej - Gandhinagar Highway, Near. Sola Bridge, Ahmedabad, Gujarat 380054