Tpa Officer

**TPA Officer**

**Location**: Kalyan
**Department**: Billing / Insurance / TPA

We are seeking a detail-oriented and organized TPA Executive to manage all third-party insurance processes within the hospital. The role involves coordinating between patients, insurance companies, and internal departments to ensure timely and accurate processing of pre-authorizations, approvals, claims, and reimbursements.

**Key Responsibilities**:
**TPA Coordination**:

- Handle daily operations related to Third-Party Administrators (insurance companies, corporates, and government schemes).
- Ensure timely submission of pre-authorization requests and follow up on approvals.
- Act as the liaison between hospital departments and TPA
- **Documentation & Records**:

- Verify and maintain accurate records of patient insurance documents.
- Ensure completeness of documentation for claim submission.
- Prepare and submit final bills to TPAs for reimbursement.
- **Claims Management**:

- Monitor claim statuses and follow up on pending or rejected claims.
- Coordinate with finance/accounts for reconciliations and payment updates.
- Maintain a database of all claims submitted and their status.
- **Patient Interaction**:

- Guide insured patients regarding TPA formalities and requirements.
- Provide assistance during admission and discharge regarding insurance processing.
- **Compliance & Reporting**:

- Ensure compliance with all insurance policies and procedures.
- Generate periodic MIS reports and submit to management.

**Qualifications**:

- Graduate in any discipline
- 1-3 years of experience in hospital TPA operations or health insurance claims
- Knowledge of hospital billing software and TPA portals

Why Join Us**:G Plus Heart Hospital & Vascular Intervention Center**, located in Kalyan West, is a multi-super specialty hospital offering a range of cardiac and other specialized services. They focus on providing world-class cardiac care and have a dedicated cardiology department with experienced doctors. The hospital also offers neurosurgery, urological surgery, nephrology, oncological surgery, orthopedic surgery, and general and laparoscopic surgery.

Pay: ₹25,000.00 - ₹40,000.00 per month

**Benefits**:

- Cell phone reimbursement
- Health insurance
- Paid sick time
- Paid time off

Work Location: In person