
Tpa Coordinator
1 day ago
Key Responsibilities:
- Handle and process cashless claims efficiently and within timelines.
- Coordinate with TPAs, insurance companies, and internal departments for smooth processing of patient admissions and discharges.
- Manage pre-authorisation, enhancement, and final approval processes for all cashless patients.
- Ensure accurate and timely documentation for CGHS, GIPSA, and private insurance claims.
- Track claim status, follow up on pending claims, and ensure timely reimbursements.
- Maintain up-to-date records and MIS reports.
- Coordinate with patients regarding insurance queries and documentation needs.
- Ensure compliance with standard protocols and hospital policies.
Requirements:
- Minimum 23 years of experience in hospital TPA operations, specifically with CGHS, GIPSA, and anywhere cashless networks.
- Strong understanding of cashless claims and insurance processes.
- Proficiency in Microsoft Excel and hospital billing software.
- Good communication and interpersonal skills.
- Ability to work under pressure and handle multiple tasks.
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