TPA Executive

3 days ago


Shivpur Varanasi Uttar Pradesh, India Octavia Hospital Full time

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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