Senior Executive TPA

2 days ago

Delhi NCR, India AIG Business Solution Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Job Title: Senior Executive TPA & Recovery

Location: Dwarka

Department: Billing / Finance / TPA

Reporting To: Manager Billing & TPA / Finance Head

Experience Required: 3–6 years in hospital TPA billing, claim submission, and recovery

Qualification: Graduate or Postgraduate (Preferably in Commerce, Hospital Administration, or Healthcare Management)

Job Summary

The Senior Executive – TPA & Recovery is responsible for managing Third Party Administrator (TPA) operations, including cashless admission processing, pre-authorization, final billing, claim submission, and recovery follow-ups. The role ensures timely coordination between the hospital, patients, and insurance companies to maximize reimbursement and maintain healthy cash flow.

Key Responsibilities

1. TPA Coordination & Admission Management

  • Coordinate with patients, consultants, and TPA representatives for cashless and insurance-based admissions.
  • Verify policy details, coverage, and exclusions at the time of admission.
  • Prepare and submit pre-authorization requests to respective TPAs or insurance companies.
  • Track and update the status of pre-auth approvals and communicate with concerned departments.

2. Billing & Documentation

  • Ensure timely and accurate preparation of interim and final bills as per the treatment and approved tariff.
  • Check completeness of documentation (doctor notes, discharge summary, investigation reports, etc.) before final claim submission.
  • Coordinate with the billing and MRD teams for discharge documents required for claim settlement.

3. Claim Submission & Recovery

  • Submit final claims to TPAs/insurance companies within TAT.
  • Regularly follow up on pending or short-settled claims and maintain recovery trackers.
  • Coordinate with TPAs for query resolution, short payments, re-submissions, and reconciliations.
  • Maintain and update claim MIS reports daily/weekly/monthly.

4. Financial & Audit Compliance

  • Ensure claim settlements are accurately recorded in the hospital's financial system.
  • Assist in reconciliation of TPA accounts with the Finance Department.
  • Support internal and external audits by providing claim and recovery data as required.

5. Communication & Coordination

  • Liaise effectively with the medical, billing, and MRD teams to resolve TPA-related issues.
  • Maintain healthy relationships with TPA executives, insurance coordinators, and corporate clients.
  • Provide patients and attendants with transparent communication regarding their claim status.

Skills & Competencies

  • In-depth knowledge of TPA/insurance claim process, pre-auth, and recovery procedures.
  • Strong understanding of medical terminology, billing codes, and tariff structures.
  • Proficiency in MS Excel, HIS (Hospital Information System), and TPA portals.
  • Excellent communication and negotiation skills.
  • Strong analytical, follow-up, and problem-solving ability.
  • Attention to detail and ability to work under tight deadlines.

Work Schedule

  • Days: Monday to Saturday
  • Timings: 9:00 AM – 6:00 PM (may vary as per hospital policy)

  • Tpa Executive

    6 days ago

    Karol Bagh, Delhi, Delhi, India SR Expert Services Full time

    Urgent Hiring For TPA Executive Urgent Hiring for TPA Executive Profile - TPA Executive Salary - 20K to 25K Experience - 3 to 7 Years Location - Karol Bagh, Delhi Qualification - Any Graduate / Post Graduate JD - Patient Handling Query reply, document submission intimation to TPA, Day to day tracking of each claim and process for approval, Having...

  • TPA Executive

    3 days ago

    Delhi, Delhi, India EEPIC Digital Full time ₹ 25,000 - ₹ 24,32,500 per year

    Job Title: TPA ExecutiveLocation: Pitampura New Delhi- 34Salary: ₹25,000 per monthExperience Required: 2–3 YearsJob Description:We are looking for a TPA Executive with 2–3 years of relevant experience in handling insurance and claims processes. The ideal candidate should have sound knowledge of Third Party Administrators (TPA), claim documentation, and...

  • Tpa Executive

    2 weeks ago

    Delhi, India Kukreja Hospital Full time

    We have requirement in TPA department at Kukreja Hospital, Mayur Vihar. Department - Front Desk Designation - TPA Executive Exp. - Min. 1 year in TPA (in Hospital Industry) Location - Mayur Vihar Phase -1 **Salary**: ₹18,000.00 - ₹25,000.00 per month **Benefits**: - Provident Fund Schedule: - Flexible shift Supplemental pay types: - Overtime...

  • Tpa Executive

    1 week ago

    Delhi, Delhi, India Mantra Care Full time

    **Job Title: TPA Executive** **Job Location**: Eye Mantra Hospital, Pachim VIhar, Delhi **Reports To**: TPA Manager / Billing and Insurance Manager **Key Responsibilities**: - **Insurance Verification and Authorization**: - Verify patient insurance details and eligibility at the time of admission or prior to medical procedures. - Liaise with the...

  • Tpa Executive

    2 weeks ago

    Delhi, NCR, India Claimfriendy Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    -Determining policy terms and con.-Evaluation of hospital bills and deductions as per insurance companies. -Deep knowledge of what is covered under insurance and what is not.-Customer Handling.-Relevant TPA or Insurance company experience.

  • Tpa Executive

    7 hours ago

    Shalimar Bagh, Delhi, Delhi, India Jain Multi-speciality Hospital Full time

    This is a job position for a TPA EXECUTIVE at our nursing home in Shalimar Bagh New Delhi. We have empanelment of most companies and regularly admit patients with health insurance. The TPA EXECUTIVE is expected to perform all responsibility expected from this position. - Carry out pre Authorization of patients being admitted. - Send enhancement of patients...

  • Tpa Executive

    4 days ago

    Delhi, Delhi, India East Delhi medical Centre Full time

    **Role Description** This is a full-time on-site role for a TPA Executive at East Delhi Medical Centre. The TPA Executive will be responsible for handling third party administration activities, coordinating with insurance companies, verifying patient insurance coverage, and ensuring timely reimbursements. **Qualifications** - Knowledge of Third Party...

  • Tpa Executive

    3 weeks ago

    NCR, India Claimfriendy Full time

    -Determining policy terms and con. -Evaluation of hospital bills and deductions as per insurance companies. -Deep knowledge of what is covered under insurance and what is not. -Customer Handling. -Relevant TPA or Insurance company experience.

  • Require for Tpa Department

    2 days ago

    Delhi, Delhi, India Park Hospital Full time

    Require for TPA Department Head - TPA **Min. 15 Years Exp.** Senior Manager - TPA **Min. 10 Years Exp.** Manager - TPA **Min. 5 Years Exp.** **Highest Salary in Industry. **Walk-in Interview on Sunday, 30th July, From 8:30 AM - 2:00 PM Venue: PARK HOSPITAL, SECTOR 47, SOHNA ROAD GURUGRAM

  • Tpa Executive

    6 days ago

    Delhi, Delhi, India Madhu Man Power Solution Full time

    Urgent Hiring ! Hiring ! Post: - TPA Executive Experience: - Minimum 1 to above Years in same field Salary: - 18k to 25k Exp: - Should be hospital backroud in same filed. Education; - Graduate from any stream. **Key Responsibilities**: Panel Management: Assist with onboarding and maintaining TPA and insurance provider panels, ensuring providers are...