Tpa Executive

7 days ago

Mumbai Maharashtra, India Hakim Ajmal Khan TMC Hospital Kausa Full time

**Key Responsibilities**:

- **Claims Management**:

- Handle the entire claims processing cycle, including claim receipt, assessment, approval, and settlement.
- Ensure claims are processed within the agreed timelines and in accordance with the policy terms.
- Coordinate with clients and service providers to resolve claim-related queries.
- **Policy Administration**:

- Manage policy documentation and ensure timely updates.
- Oversee the renewal process and work with clients to ensure accurate information is provided.
- Assist in the issuance of policies, amendments, and endorsements.
- **Client Relationship Management**:

- Serve as the primary point of contact for clients regarding TPA services.
- Address client concerns and provide effective solutions in a timely manner.
- Conduct regular meetings with clients to assess satisfaction levels and identify areas for improvement.
- **Compliance and Reporting**:

- Ensure all processes adhere to company policies, industry regulations, and legal requirements.
- Prepare and submit regular reports on claims, policy status, and performance metrics.
- Assist in audits and handle documentation requirements.
- **Coordination with Internal and External Stakeholders**:

- Collaborate with insurance companies, service providers, medical professionals, and other external parties to facilitate smooth operations.
- Work closely with the internal team to ensure effective communication and process flow.
- **Data Analysis and Process Improvement**:

- Monitor claim trends and propose improvements for efficiency and cost reduction.
- Analyze performance data and suggest strategies to enhance service quality.
- **Customer Support**:

- Provide excellent customer support by responding to queries and resolving issues.
- Assist customers in understanding policy terms, claim processes, and benefits.
- call
- 9987225914

Pay: ₹12,000.00 - ₹16,000.00 per month

Schedule:

- Day shift
- Morning shift

**Experience**:

- TPA Executive: 2 years (required)

Work Location: In person

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