Tpa Coordinator

4 days ago


Rewari HR IN Women Pride Hospital & IVF Full time

Job Title TPA Coordinator Department Claims Health Insurance HR Administration depending on the organization Reports To Manager - Claims Administration HR Location REWARI Job Type Full-Time Job Summary The TPA Coordinator is responsible for managing and coordinating all aspects of third-party administrator TPA interactions including health insurance claims reimbursements empanelment of hospitals and policy administration The role ensures smooth communication between the organization TPA and employees or clients facilitating efficient healthcare or insurance services Key Responsibilities Serve as the primary point of contact between the organization and the TPA Coordinate and monitor claim submissions approvals and settlements Handle policy enrollments endorsements renewals and cancellations with the TPA Facilitate empanelment and communication with hospitals clinics or service providers Address and resolve claim-related issues or disputes with TPA or service providers Assist employees customers with health insurance queries documentation and claim processes Maintain up-to-date records of claims policies and communications Ensure timely and accurate data entry in internal and TPA systems Generate and share regular reports on claims status TAT Turnaround Time and other KPIs Ensure compliance with company policies IRDAI Insurance Regulatory and Development Authority of India norms and other regulatory guidelines Conduct periodic audits or reviews of TPA performance and recommend improvements Required Qualifications and Skills Bachelor s degree in healthcare business administration insurance or a related field 2-5 years of experience in a similar TPA coordination or insurance claims role Good knowledge of health insurance policies claim processes and IRDAI regulations Excellent communication and interpersonal skills Strong organizational and multitasking abilities Proficiency in MS Office Excel Word PowerPoint Ability to handle sensitive information with confidentiality and integrity Preferred Qualifications Prior experience working with insurance companies or TPAs Familiarity with hospital billing and coding processes Job Type Full-time Pay 10 000 00 - 30 000 00 per month Benefits Health insurance Schedule Day shift Supplemental Pay Overtime pay Work Location In person


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