Tpa Executive

1 day ago

Dhanori Pune Maharashtra, India Bapat Multispeciality Hospital Full time

**Department**: Billing / Finance / TPA
**Reports To**: TPA Manager / Billing Head / Hospital Administrator
**Employment Type**: Full-time

**Job Summary**:
The TPA (Third Party Administrator) Executive is responsible for coordinating and managing all aspects related to cashless insurance and TPA billing operations in the hospital. This includes pre-authorization, insurance documentation, claim submissions, and following up with TPAs/insurance companies to ensure timely settlement of claims.

**Key Responsibilities**:

- **Pre-Authorization & Admission Process**:

- Coordinate with the treating doctor to obtain necessary medical information for pre-authorization.
- Submit pre-authorization requests to the respective TPAs/insurance companies.
- Follow up for approval and inform patients/attendants accordingly.
- **Insurance Documentation**:

- Collect and verify insurance documents from patients at the time of admission.
- Ensure all required forms (insurance card, ID proof, policy documents, etc.) are accurately filed.
- **Claim Management**:

- Prepare and submit claims to TPAs/insurance companies with proper documentation.
- Monitor claim status and follow up for pending payments or rejections.
- Handle queries and rejections, resubmit claims as needed.
- **Discharge Process**:

- Coordinate with medical, nursing, and billing teams to prepare final bill.
- Submit final bill to the TPA for final approval before discharge.
- Ensure timely issuance of discharge summary and final bill approval.
- **Coordination & Communication**:

- Maintain effective communication with patients, insurance companies, TPAs, and internal departments.
- Explain insurance policies and billing procedures to patients.
- **Reporting & Documentation**:

- Maintain daily reports of admissions, approvals, discharges, and claim submissions.
- Maintain up-to-date records of insurance companies and TPA contacts.
- Ensure compliance with internal hospital policies and insurance norms.

**Key Skills & Competencies**:

- Knowledge of health insurance policies and TPA processes
- Good communication and interpersonal skills
- Attention to detail and accuracy
- Time management and ability to handle pressure
- Proficiency in MS Office and hospital billing software (HIS)

**Educational Qualifications**:

- Bachelor's degree in any discipline (Commerce, Healthcare Administration preferred)
- Certification or training in medical billing/TPA management is an advantage

**Experience**:

- Minimum 1-3 years of experience in TPA operations or hospital billing
- Experience in working with multiple insurance providers and TPAs

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

Pay: ₹20,000.00 - ₹35,000.00 per month

Work Location: In person

  • TPA Executive

    1 day ago

    Dhanori, Pune, Maharashtra, India Bapat Multispeciality Hospital Full time ₹ 2,40,000 - ₹ 4,20,000 per year

    Department: Billing / Finance / TPAReports To: TPA Manager / Billing Head / Hospital AdministratorEmployment Type: Full-timeJob Summary:The TPA (Third Party Administrator) Executive is responsible for coordinating and managing all aspects related to cashless insurance and TPA billing operations in the hospital. This includes pre-authorization, insurance...

  • Tpa Executive

    2 weeks ago

    Dhanori, Pune, Maharashtra, India Bapat Multispeciality Hospital Full time

    TPA (Third-Party Administrator) Executive is responsible for handling all insurance and cashless hospitalization Skills:Oversee and manage the billing and claim submission process for TPAs. Ensure timely, accurate, and complaint submission of claims and invoices. Duty hours as per industry standards. **Job Types**: Full-time, Permanent Pay: ₹15,000.00...

  • Tpa Executive

    2 weeks ago

    Pune, India Rao Hospital Full time

    Urgent hiring TPA Executive for reputed multispeciality hospital at Pune. Qualification : Any Graduate/ Post Graduate Experience : Relevant 2+ years experience with 50+ beded hospital is required. 1. Well versed and experienced with all protocols and procedures for TPA patients. 2.To handle all TPA patients and their queries. 3. Ensure all money is...

  • Tpa Coordinator and Tpa Executive

    5 days ago

    Borivali, Mumbai, Maharashtra, India Karuna Hospital Full time

    TPA Coordinator - acts as a bridge between patients, hospitals, and insurance companies by managing the Third-Party Administrator (TPA) process for health insurance claims. Responsibilities include facilitating cashless approvals, processing claims, coordinating patient admissions and discharges, preparing billing documents, maintaining relationships with...

  • Billing & Tpa Executive

    5 days ago

    Pune, India Lotus Hospital Full time

    We are hiring Billing/ TPA Executive with 3+ years relevant experience at Pune. Salary : Rs.20,000/- to Rs.30,000/ - Notice Period : Immed/ max 10-15 Days. Schedule: - Day shift Ability to commute/relocate: - Pune - 411021, Maharashtra: Reliably commute or planning to relocate before starting work (preferred) **Experience**: - Billing & TPA...

  • Tpa Billing executive

    2 weeks ago

    Pune, India Medico Hub Full time

    Contact Mr Nishant Chaudhary WhatsApp Job Title: TPA / Billing Executive Location: Talegaon, Pune, Maharashtra Job Type: Full-Time About The RoleWe are looking for a detail-oriented and proactive TPA / Billing Executive to manage the billing operations and Third Party Administrator (TPA) processes at our healthcare facility. The ideal candidate should have...

  • Tpa Billing executive

    2 weeks ago

    Pune, India Medico Connect Full time

    Job Title: TPA / Billing Executive Contact Mr Nishant Chaudhary WhatsApp Location: Talegaon, Pune, MaharashtraJob Type: Full-Time About the Role We are looking for a detail-oriented and proactive TPA / Billing Executive to manage the billing operations and Third Party Administrator (TPA) processes at our healthcare facility. The ideal candidate should have...

  • Tpa Billing executive

    1 day ago

    Pune, Maharashtra, India Medico Hub Full time ₹ 6,00,000 - ₹ 8,00,000 per year

    Contact Mr Nishant Chaudhary WhatsApp Job Title: TPA / Billing ExecutiveLocation: Talegaon, Pune, MaharashtraJob Type: Full-TimeAbout The RoleWe are looking for a detail-oriented and proactive TPA / Billing Executive to manage the billing operations and Third Party Administrator (TPA) processes at our healthcare facility. The ideal candidate should have...

  • Tpa Billing executive

    1 day ago

    Pune, Maharashtra, India Medico Connect Full time ₹ 6,00,000 - ₹ 8,00,000 per year

    Job Title: TPA / Billing ExecutiveContact Mr Nishant Chaudhary WhatsApp Location: Talegaon, Pune, MaharashtraJob Type: Full-TimeAbout the RoleWe are looking for a detail-oriented and proactive TPA / Billing Executive to manage the billing operations and Third Party Administrator (TPA) processes at our healthcare facility. The ideal candidate should have...

  • Tpa Empanelment Executive

    7 days ago

    Pune, India V3 Infosolutions Full time

    **Roles and Responsibilities**: - TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. - Liaison with Govt. Health Departments. - Liaison with Insurance Companies. - Tie ups with Corporate Houses. - Must be aware of norms of insurance sector. - Excellent English communication. - Must have good command over MS Office. - Must have experienced of...