Tpa Executive

1 week ago

Lucknow Uttar Pradesh, India Dr KNS Memorial Hospital (Formerly Mayo Hospital) Full time

As a TPA Executive, you will be responsible for managing and overseeing various aspects of third-party administration services for clients
- Your primary goal will be to ensure the smooth and efficient processing of claims and other administrative functions while maintaining high levels of customer satisfaction
- You will collaborate with internal teams and external stakeholders to deliver exceptional service and meet client expectations
- Responsibilities:Claims Management: Handle and process insurance claims efficiently and accurately, adhering to the company's guidelines and relevant regulations
- Client Communication: Serve as the main point of contact for clients, addressing inquiries, resolving issues, and providing updates on claim statuses
- Policy Administration: Review and validate insurance policy details to ensure correct coverage and policy benefits for claim processing
- Documentation and Record Keeping: Maintain accurate records of all claim-related documents, transactions, and communications
- Coordination with Healthcare Providers: Liaise with hospitals, doctors, and other healthcare providers to facilitate the smooth processing of medical claims
- Network Management: Collaborate with the network management team to maintain a strong network of healthcare providers and negotiate contracts with them
- Quality Assurance: Implement and maintain quality assurance processes to ensure accurate and timely claim processing
- Reporting: Prepare and present reports on claim processing metrics, performance, and client satisfaction

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

Pay: ₹18,000.00 - ₹26,000.00 per month

Schedule:

- Evening shift
- Morning shift

**Experience**:

- total work: 1 year (required)

Work Location: In person

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