Tpa Executive

7 days ago

Nagpur Maharashtra, India Sath Outsourcing Service pvt. Ltd. Full time

**Position Overview**: A **TPA Executive** manages the relationship between the insurance company, healthcare providers, and customers, ensuring smooth processing of health insurance claims and customer support. This role involves overseeing claims processing, verifying policy coverage, coordinating with hospitals, and resolving queries related to insurance claims. The TPA Executive is responsible for ensuring compliance with policies and regulatory standards while maintaining excellent customer service.

Key Responsibilities:

- **Claims Processing and Management**:

- **Policy Verification and Authorization**:

- **Coordination with Healthcare Providers**:

- **Customer Service and Support**:

- **Reporting and Documentation**

Qualifications and Skills:

- **Education**: Any
- **Experience**: minimum 1 years of experience in health insurance, TPA services, or claims management.
- **Skills**:

- Strong communication and interpersonal skills for effective collaboration and customer interaction.
- Knowledge of health insurance policies, claims processing, and hospital/TPA operations.
- Proficiency in MS Office and familiarity with insurance or TPA software.

Desired Qualities:

- **Detail-Oriented**: Excellent attention to detail for verifying claims and documentation accuracy.
- **Problem-Solving Skills**: Ability to handle escalations and find quick solutions to policy or claim issues.
- **Customer-Focused**: Commitment to providing excellent customer service and support.

Working Conditions:

- Office-based role with possible travel to healthcare provider locations.
- Some extended hours may be required during peak periods or in cases of high claim volumes.

This role is vital in ensuring efficient and accurate claims processing, managing policyholder and provider relationships, and supporting a seamless customer experience in health insurance administration.

**Contact : 8625863596(HR Apurva)**

**Job Types**: Full-time, Permanent

Pay: ₹15,000.00 - ₹18,000.00 per month

**Benefits**:

- Health insurance

Schedule:

- Day shift
- Rotational shift

Supplemental Pay:

- Yearly bonus

**Experience**:

- total work: 1 year (preferred)

Work Location: In person

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