Corporate and Tpa Co-ordinator

5 days ago

Nashik Maharashtra, India Nimai Institute of Medical Sciences Pvt Ltd Full time

**Job Summary**:
The Corporate and TPA (Third Party Administrator) Coordinator serves as the liaison between the hospital, insurance companies, TPAs, and corporate clients. This role ensures smooth coordination for patient admissions, billing, approvals, and discharge processes for insured and corporate patients, ensuring timely cashless approvals and efficient claim processing.

**Key Responsibilities:1. Admission Coordination**:

- Verify insurance or corporate tie-up at the time of patient registration.
- Collect necessary documents (ID proof, insurance cards, etc.) for cashless processing.
- Coordinate with the TPA/insurance/corporate client for pre-authorization.
- Maintain accurate documentation of all communications.

**2. Pre-authorization and Approvals**:

- Submit pre-authorization requests with required medical details.
- Follow up on pending approvals or queries raised by the TPA.
- Escalate delays in approvals to concerned authorities.

**3. Discharge Coordination**:

- Liaise with the billing and medical teams to ensure timely discharge intimation to TPA/corporate.
- Submit final bills and discharge summaries for final approval.
- Ensure collection of final approval letter before patient discharge.

**4. Claim Management**:

- Compile and verify all documents for claim submission (bills, investigation reports, case papers, etc.).
- Coordinate with TPA/insurance companies for claim settlement.
- Maintain detailed records of claim submissions and receivables.

**5. Corporate Client Coordination**:

- Act as the primary contact for all corporate clients.
- Ensure adherence to corporate billing agreements and terms.
- Provide MIS reports to corporate clients as required.

**6. Communication & Documentation**:

- Maintain up-to-date logs of all approvals, denials, pending claims, and escalations.
- Ensure all documentation complies with TPA and insurance guidelines.
- Regularly update patients and families on the status of approvals and discharges.

**7. Compliance and Audit**:

- Ensure compliance with all regulatory and insurance requirements.
- Support audits and resolve any discrepancies related to TPA/corporate billing.

Pay: ₹20,000.00 - ₹30,000.00 per month

**Benefits**:

- Provident Fund

Schedule:

- Day shift

Application Question(s):

- How many years of experience do you have in TPA/Corporate Coordination or hospital billing?
- What is your highest educational qualification?
- What is your current notice period?
- What is your current monthly salary (CTC)?
- What are your salary expectations for this role?

Work Location: In person

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