Tpa Coordinator

**Designation-**Executive in Claims **Job Location**:Jaipur **Industry-Health Insurance or TPA Company** **Immediate Joiner required.** **Job Description**: **Key Responsibilities**: **Claims Processing**: 2.Review and process health insurance claims as per policy guidelines and SLA timelines. 3.Coordinate with hospitals, clients, and internal teams for...

KR Business Solutions (KR) is a prominent management consulting service provider that offers "requirement-based" services to hospitals and healthcare organizations throughout India. We offer empanelment consulting, quality accreditations (NABH/NABL/ISO), cashless/reimbursement claim settlement, and hospital planning and development. We have been established...

Role OverviewThe TPA Manager will be responsible for overseeing all operations related to private insurance, TPAs, and government health schemes including Bhamashah Swasthya Bima Yojana (BSBY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). The role ensures smooth cashless and reimbursement processes, timely approvals, and compliance with all...

**Description** **Requirements**: - Minimum 3 years experience in hospital as TPA coordinator. - Any graduate/ Post graduate - Language proficiency in English and Hindi. **Duties & Responsibilities**: - Helping customers choose, modify an insurance plan that fits their needs and budget. - Daily check list of patients who have insurance, collect and...

Role Overview The TPA Manager will be responsible for overseeing all operations related to private insurance, TPAs, and government health schemes including Bhamashah Swasthya Bima Yojana (BSBY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) . The role ensures smooth cashless and reimbursement processes, timely approvals, and compliance with all...

Role OverviewThe TPA Manager will be responsible for overseeing all operations related to private insurance, TPAs, and government health schemes including Bhamashah Swasthya Bima Yojana (BSBY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) . The role ensures smooth cashless and reimbursement processes, timely approvals, and compliance with...

Role & responsibilitiesCoordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements.Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format.Follow up regularly with TPAs for claim status, pending queries, and settlement updates.Verify patient insurance details,...

Job Description Role Overview The TPA Manager will be responsible for overseeing all operations related to private insurance, TPAs, and government health schemes including Bhamashah Swasthya Bima Yojana (BSBY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). The role ensures smooth cashless and reimbursement processes, timely approvals, and...

**Role : Medical Officer - CLAIM PROCESSING** 1.Medical Scrutiny by thorough assessment of documents. 2.Provide Medical opinion on admissibility of Insurance Claims. 3.Proficient with medical terms & system. 4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines. 5.Understanding of Claims...

Vidal is hiring for Claims-Executive Work Location: Gurgaon **Work from Office only** **Key Responsibilities** **Claim Review & Validation** - Examine submitted claims for completeness and accuracy - Verify policy coverage and eligibility - Identify discrepancies or missing documentation **Claims Processing** - Enter and adjudicate claims in the system...