[High Salary] Tpa Medical Officer
3 weeks ago
Key Responsibilities 1 Pre-authorization Claim Management Review and validate pre-authorization requests as per medical necessity and insurance policy guidelines Prepare and submit pre-authorization forms with accurate diagnosis procedure codes and estimated costs Monitor approval status and follow up with TPAs for timely authorization Scrutinize final bills discharge summaries and investigation reports before claim submission 2 Coordination Communication Coordinate with consultants nursing staff and billing teams for complete documentation Communicate with TPA coordinators and insurance executives for approvals queries or discrepancies Handle patient or attendant queries related to insurance coverage and approvals 3 Documentation Compliance Ensure all treatment notes prescriptions and reports are attached to claims Maintain accurate and complete records of all TPA-related activities Verify compliance with IRDA and hospital policies regarding TPA operations 4 Medical Review Evaluate the medical justification of treatment plans and hospital stay Cross-check diagnosis and procedure coding ICD CPT to avoid rejections Assist in preparing medical justifications for claim rejections or queries 5 Reporting Prepare daily weekly monthly MIS reports on TPA cases pending approvals and claim settlements Track and analyze TPA claim rejection trends to improve documentation accuracy Skills Competencies Strong medical assessment and analytical skills Good communication and coordination abilities Knowledge of insurance policies and hospital billing systems Attention to detail and documentation accuracy Proficiency in MS Office and HIS Hospital Information System Qualifications Experience Education MBBS BAMS BHMS MBBS preferred Experience Minimum 1-3 years in hospital TPA department insurance claim processing utilization review Knowledge Medical coding ICD CPT TPA software systems and hospital billing Insurance claim workflow and pre-authorization process Job Types Full-time Permanent Pay 30 597 71 - 45 512 63 per month Benefits Cell phone reimbursement Leave encashment Paid sick time Paid time off Provident Fund Education Bachelor s Preferred Experience TPA 2 years Preferred Work Location In person
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Tpa Executive
11 hours ago
Darbhanga, India S N Sarraf Hospital Full timeA Third Party Administrator (TPA) is a company that provides services to insurance companies and policyholders. A TPA's job description can include: - **Claims processing**TPAs manage the claims process from start to finish, including receiving and reviewing documents, verifying eligibility, assessing the claim, and disbursing payment. - **Benefits...
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Gandhinagar, GJ, IN Medi Assist Insurance TPA Private Limited Full timeResponsibilities 01 Involves Processing of Claims Preauthorization Reimbursement claims 02 Validating and processing these claims within TAT 03 With good communication and medical Knowledge 04 TPA Experience is an added advantage Financial To see to that there is no financial implication for the organization while settlement of claims Role Medical Officer...
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Tpa Executive
2 weeks ago
Raiganj, WB, IN Jeevan Rekha Hospital Full timeKey Responsibilities Handle cashless authorization claim intimation and final settlement processes Coordinate with doctors patients and insurance representatives for case handling and query resolution Review and verify patient documents medical records and discharge summaries for claim accuracy Manage communication between hospital departments and TPA...
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Tpa Officer
7 days ago
Kalyan, MH, IN G Plus Heart Hospital & Multi Super Speciality Center Full timeTPA Officer Location Kalyan Department Billing Insurance TPA We are seeking a detail-oriented and organized TPA Executive to manage all third-party insurance processes within the hospital The role involves coordinating between patients insurance companies and internal departments to ensure timely and accurate processing of pre-authorizations approvals claims...
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Tpa Desk Coordinator
1 week ago
Bahadurgarh, HR, IN Medark hospital Full timeTPA Desk Coordinator Location Medark Hospital Bahadurgarh Department Billing Insurance TPA Desk Role Full-time Reports to Billing Manager Hospital Administrator Position Overview The TPA Desk Coordinator will be responsible for managing all activities related to cashless hospitalization insurance approvals patient coordination and documentation The role...
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Tpa Executive
1 week ago
Kurukshetra, HR, IN Ujala Cygnus Super Speciality Hospital Kurukshetra Full timeJob Title TPA Executive Location Cygnus Superspeciality Hospital Kurukshetra Job Type Full-time About Us Cygnus Superspeciality Hospital Kurukshetra is a leading healthcare provider committed to delivering quality patient care We are seeking a dedicated TPA Executive to manage insurance and TPA-related activities efficiently Key Responsibilities Coordinate...
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Mrd Incharge
5 days ago
Darbhanga, BR, IN Swami vivekananda cancer hospital, darbhanga Full timeKey Responsibilities1 Medical Records Management Ensure proper collection indexing classification filing and archiving of all patient records IPD OPD Emergency Maintain patient discharge files ensure completeness and obtain missing documents from respective departments Ensure timely assembly and coding of medical records as per ICD-10 ICD-11 standards...
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Resident Medical Officer
2 weeks ago
Raiganj, WB, IN Ohm Jobs Full timeJob Title Resident Medical Officer RMO Senior Medical Officer Location Raiganj West Bengal Accommodation Provided by the hospital Qualification MBBS or BHMS Registered with respective council Experience Minimum 2 years in hospital settings preferred Reporting To Hospital Administrator Medical Superintendent Job Summary We are seeking a dedicated and...
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Tpa Coordinator
2 weeks ago
Rewari, HR, IN Women Pride Hospital & IVF Full timeJob 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...
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Corporate & Tpa Liaison Executive
1 week ago
Dibrugarh, AS, IN Swastha Hospital Full timeThe Corporate TPA Liaison Executive will be responsible for developing maintaining and expanding Swastha Hospital s market presence through strategic marketing initiatives corporate tie-ups TPA relations and empanelment s The role demands active engagement with doctors corporate clients insurance partners and community stakeholders to drive patient footfall...