Tpa & Insurance Coordinator

3 days ago

Varanasi Uttar Pradesh, India ZenOnco.io Full time

**TPA & Insurance Empanelment**
- Identify and approach TPAs and private insurance companies for empanelment.
- Prepare and submit all required documentation for empanelment.
- Coordinate site visits and inspections by insurers/TPAs.
- Maintain records of empanelment agreements, renewals, and updates.

**Pre-Authorization & Claim Processing**
- Manage the process of obtaining pre-authorization approvals for insured patients.
- Ensure timely submission of final bills and discharge summaries for claim processing.
- Track claim status and respond to queries raised by insurance companies/TPAs.
- Liaise with doctors, billing, and medical records departments to ensure claim accuracy.

**Patient Coordination**
- Explain the insurance process to patients and caregivers.
- Collect all necessary insurance documents from patients.
- Follow up with patients for balance payments not covered by insurance.
- Assist in converting cash patients to insurance-based treatment if eligible.

**Follow-Up for Payments**
- Track outstanding payments from TPAs, insurance companies, and patients.
- Coordinate with the finance team to reconcile received payments.
- Maintain daily reports of payment status and claims pending.

**Key Skills & Requirements**:

- Bachelor's degree (preferably in healthcare, administration, or commerce)
- 2+ years of experience in TPA/insurance handling in a hospital setup
- Familiar with TPA portals and insurance company procedures
- Good communication and follow-up skills
- Detail-oriented, with strong documentation and organizational ability
- Ability to handle pressure and work independently

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

Pay: ₹12,000.00 - ₹25,000.00 per month

Schedule:

- Day shift
- Morning shift

Work Location: In person

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