TPA Coordinator

20 hours ago

Raigarh Fort Maharashtra, India Martech Simplified Full time ₹ 1,80,000 - ₹ 2,40,000 per year

Job Title: TPA Coordinator

Department: TPA (Third-Party Administrator)

Location: Multispecilaity in Panvel

Salary: ₹15,000 to ₹ 20,000 per month

Job Summary:

A Hospital is looking for a dedicated and detail-oriented TPA Coordinator to join the team. The TPA Coordinator will be responsible for managing the interaction between the hospital and third-party administrators, ensuring smooth processing of insurance claims, and providing support to patients throughout the insurance verification and claim process. This is a full-time position based at our Khanda Colony, Panvel branch.

Key Responsibilities:

  • Insurance Verification: Coordinate with insurance companies and third-party administrators to verify patient insurance details, coverage, and eligibility.
  • Claims Processing: Handle all aspects of claim processing, including documentation, submission of claims, and follow-up to ensure timely settlement of claims.
  • Patient Assistance: Assist patients in understanding their insurance coverage and guide them through the pre-authorization process.
  • Data Management: Maintain accurate records of insurance claims, approvals, and denials. Ensure all relevant documentation is available and updated in the system.
  • Coordination with Hospital Departments: Collaborate with various hospital departments to gather necessary information for insurance claims and approvals.
  • Pre-Authorization: Ensure pre-authorization requests are processed for surgeries, procedures, and hospital admissions as per insurance guidelines.
  • Billing Support: Work closely with the billing department to resolve any discrepancies between hospital charges and insurance reimbursements.
  • Follow-Up: Follow up with insurance companies regarding pending claims and payment status, ensuring timely resolution.
  • Customer Service: Provide excellent service to patients and their families, addressing queries regarding insurance-related matters and resolving any issues that may arise.

Qualifications & Skills:

  • Education: Graduate in any stream; a background in healthcare administration or insurance is a plus.
  • Experience: Prior experience in TPA or insurance coordination in a hospital or healthcare setting is preferred.
  • Skills:
  • Strong communication skills (both verbal and written).
  • Good organizational skills with attention to detail.
  • Ability to work under pressure and meet deadlines.
  • Basic knowledge of health insurance policies, procedures, and claim settlement processes.
  • Proficiency in MS Office (Word, Excel) and hospital management software.
  • Ability to handle sensitive patient information with confidentiality.

Additional Requirements:

  • Positive attitude and willingness to work in a team-oriented environment.
  • Ability to work flexible hours when necessary, including weekends and holidays.
  • Basic understanding of medical terminology is a plus.

Benefits:

  • Opportunity to work with a leading hospital in the Panvel region.
  • Learning and development opportunities in the healthcare and insurance sector.

How to Apply:

Interested candidates are invited to send their resume to or call at

Job Type: Full-time

Pay: ₹15, ₹20,000.00 per month

Work Location: In person

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