Receptionist+tpa Excuitive(Tpa)

2 days ago

Borivali Mumbai Maharashtra, India Pravaayu Healthcare Pvt Ltd Full time

Job Title: TPA Executive
Location: [Insert Location]
Department: [Insert Department]
Reports To: [Insert Reporting Manager's Title]
Job Summary:
The TPA Executive will be responsible for managing Third-Party Administrator (TPA) processes
within the hospital, ensuring efficient front desk operations, effective customer interactions,
meticulous insurance oversight, and accurate administrative documentation.
Key Responsibilities:
Front Desk Management:

- Serve as the initial point of contact for patients and visitors, ensuring a welcoming and
efficient environment.
- Oversee front desk operations, including patient check-in, appointment scheduling, and
coordination with various hospital departments.
Customer Interaction:

- Address patient and family inquiries regarding insurance coverage, claim statuses, and
hospital services.
- Provide guidance on pre-authorization processes and assist in resolving any concerns
related to insurance claims.
Insurance and TPA Oversight:

- Manage the entire claims process, from initiating pre-authorization requests to final claim
settlements. Coordination with tpa department
- Coordinate with insurance companies to validate coverage, expedite approvals, and
addredss any discrepancies.
- Maintain accurate records of all insurance transactions, ensuring compliance with
regulatory standards.
Administrative Documentation:

- Handle all necessary documentation related to insurance claims, patient admissions,
and medical records.
- Prepare and submit reports as required by hospital administration and regulatory bodies.
- Ensure confidentiality and security of all patient and insurance-related information.
Qualifications:
Any Graduate can apply
- At least 1years of experience in TPA or healthcare insurance sector.
- Strong understanding of healthcare policies, insurance regulations, and claims
processing.
- Excellent communication and interpersonal skills.
- Exceptional problem-solving abilities and attention to detail.
Working Conditions:

- Full-time position with standard working hours.
- Location:Borivali

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

Pay: ₹15,000.00 - ₹20,000.00 per month

Schedule:

- Day shift

**Location**:

- Borivali, Mumbai, Maharashtra (preferred)

Work Location: In person

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