Tpa Manager

1 Educational Qualifications Bachelor s degree in business administration Healthcare Management Insurance Finance or related field MBA or postgraduate diploma in Healthcare Management Insurance preferred 2 Work Experience Minimum 3-6 years experience in hospital TPA management health insurance or claims processing Experience handling TPA coordination claim settlements and insurance approvals in a hospital environment Knowledge of insurance policies claim procedures and regulatory guidelines 3 Core Skills Knowledge Managing and coordinating with TPAs for smooth claims processing Understanding of insurance policy terms claim documentation pre-authorization and discharge approvals Monitoring and follow-up of claim rejections disputes and escalations Preparing reports on claim status approvals denials and financial reconciliation 4 Technical Skills Familiarity with Hospital Information Systems HIS and TPA portals Proficiency in MS Excel for data analysis and reporting Use of email and communication tools for vendor coordination 5 Communication Negotiation Skills Strong verbal and written communication skills for interaction with insurance companies hospital departments and patients Negotiation skills to resolve claim disputes and expedite approvals 6 Compliance Documentation Ensuring timely and accurate submission of documents as per insurance and hospital policies Maintaining audit-ready claim files and records Knowledge of healthcare regulations and insurance compliance requirements 7 Performance Indicators Claim settlement turnaround time Reduction in claim rejection rates Accuracy and completeness of claim documentation Effective dispute resolution rate TPA vendor satisfaction and relationship management Job Types Full-time Permanent Pay 25 000 00 - 50 000 00 per month Benefits Leave encashment Paid sick time Paid time off Education Master s Preferred Experience TPA 2 years Preferred Work Location In person