Hiring for Hospital Tpa

3 days ago

Andheri Mumbai Maharashtra, India Mandke Hospital Support Services Ltd Full time

A TPA (Third Party Administrator) job in a hospital involves acting as a liaison between patients, hospitals, and insurance companies to process claims, manage health insurance policies, and resolve billing issues.

**Key Responsibilities**
- Claim Management: Coordinate the end-to-end TPA process for insurance claims, from patient admission to discharge, ensuring accurate documentation and billing.
- Insurance Verification: Review and verify patient health insurance coverage, eligibility, and policy benefits to ensure claims are processed within scope.
- Liaison with Insurers: Act as the hospital's representative to interact with insurance companies and their TPAs, following up to clear claims and authorize treatments.
- Patient Support: Guide patients on insurance processes, explain policy inclusions/exclusions, and provide information on claim status and reimbursement procedures.
- Documentation & Records: Maintain accurate records of all patient and stakeholder interactions and process patient claims, ensuring the correct submission of information and documentation.
- Portal Management: Handle and manage TPA online portals, which are used for submitting and tracking claims and other related transactions.
- Reconciliation: Update and reconcile implant bills to ensure accurate financial records.
- Reporting: Prepare and share regular reports, including MIS (Management Information System) reports, to inform management about TPA operations.

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

Pay: ₹18,000.00 - ₹25,000.00 per month

**Benefits**:

- Health insurance
- Provident Fund

**Education**:

- Bachelor's (preferred)

**Experience**:

- TPA: 1 year (preferred)

**Language**:

- English (preferred)

Work Location: In person

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