TPA Executive
3 days ago
Job Title: TPA Executive
Department: Billing
Reporting To: Billing Manager
Job Responsibilities:
- Coordinate with TPAs and insurance companies for cashless hospitalization cases.
- Collect, verify, and submit all required documents for pre-authorization and final claims.
- Ensure timely approval of pre-auth and follow up for pending cases.
- Prepare and submit final bills, discharge summaries, and supporting medical documents.
- Regularly follow up with TPAs/insurance companies for claim settlement.
- Resolve queries, discrepancies, and rejections raised by TPAs.
- Maintain proper records of cashless and reimbursement cases.
- Update patients and attendants regarding claim status and requirements.
- Coordinate with doctors, nursing staff, billing, and accounts departments.
- Ensure compliance with hospital policies and TPA guidelines.
- Prepare daily/monthly TPA MIS and reports.
Eligibility & Skills:
- Graduate in any discipline (Healthcare / Hospital Management preferred).
- 1–3 years experience in hospital TPA / insurance desk.
- Knowledge of medical terminology, ICD codes, and billing processes.
- Familiar with cashless & reimbursement claim procedures.
- Good communication and coordination skills.
- Proficient in MS Office and Hospital Information Systems (HIS).
Key Competencies:
- Attention to detail
- Time management
- Patient handling
- Problem-solving skills
Work Location: Hospital / Healthcare Facility
Shift: Morning/Evening/Night/ Rotational (as per hospital requirement)
Job Types: Full-time, Permanent
Pay: ₹15, ₹20,000.00 per month
Work Location: In person
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