TPA Coordinator

Job Description:

We are seeking a dedicated and detail-oriented
TPA (Third Party Administrator) Coordinator
to join our team. The TPA Coordinator will be responsible for managing all activities related to TPA operations, including coordination with insurance companies, claim settlement, documentation, and ensuring smooth cashless hospitalization processes for patients.

Key Responsibilities:

• Coordinate with TPAs and insurance companies for cashless hospitalization approvals and claims settlement.
• Verify and process pre-authorization requests and insurance documents.
• Maintain accurate records of insurance approvals, rejections, and pending cases.
• Ensure compliance with all TPA guidelines and hospital policies.
• Handle queries from patients and their families regarding insurance coverage and documentation.
• Follow up with TPAs/insurance companies for timely claim settlements.
• Prepare and submit required MIS reports related to TPA activities.
• Work closely with hospital billing and finance teams for reconciliation of claims.

Requirements:

• Bachelor's degree in any discipline (Healthcare/Insurance background preferred).
• 1–3 years of experience in TPA coordination, hospital billing, or health insurance sector.
• Strong communication and interpersonal skills.
• Good knowledge of health insurance policies and TPA processes.
• Proficiency in MS Office (Excel, Word).
• Ability to work under pressure and handle multiple cases simultaneously.

Benefits:

• Competitive salary package.
• Health insurance and other employee benefits.
• Opportunity to work in a growing healthcare organization.
• Professional development and training support.