Tpa/ Ayushman Billing Executive
1 week ago
Coordinate with insurance companies and TPAs for pre-authorizations, approvals, and claim settlements.
- Collect and verify insurance documentation from patients.
- Submit pre-authorization requests and follow up on approvals.
- Prepare and submit final bills with supporting documents to TPAs.
- Maintain updated records of TPA empanelments, policies, and tariffs.
- Liaise with the finance department for reconciliation of TPA payments.
- Register eligible beneficiaries under Ayushman Bharat using the BIS portal.
- Verify patient documents and eligibility as per government guidelines.
- Process e-card issuance and beneficiary identification.
- Submit pre-authorization requests on the Ayushman Bharat portal.
- Ensure proper documentation and timely upload of treatment and discharge summaries.
- Generate and submit claims through TMS (Transaction Management System).
- Coordinate audits and inspections related to Ayushman Bharat.
- Ensure compliance with NHAB protocols and reporting standard
- 1-3 years of experience in hospital billing, insurance processing, or TPA coordination.
- Familiarity with Ayushman Bharat guidelines, BIS & TMS portals.
- Strong communication and coordination skills.
- Attention to detail and ability to handle multiple cases simultaneously.
- Proficiency in MS Office and billing software.
Schedule:
- Day shift
Work Location: In person
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