TPA Desk coordinator

Job Description: TPA Desk Coordinator

Location: Medark Hospital, Bahadurgarh

Department: Billing & Insurance / TPA Desk

Role: Full-time

Reports to: Billing Manager / Hospital Administrator

Position Overview

The TPA Desk Coordinator will be responsible for managing all activities related to cashless hospitalization, insurance approvals, patient coordination, and documentation. The role demands excellent communication, strong follow-up skills, accuracy, and an understanding of hospital billing & insurance workflows.

Key Responsibilities1. Patient Registration & Verification

• Verify patient's insurance policy details, eligibility, and required documents.
• Explain cashless procedures and documentation requirements to patients & attendants.
• Ensure all pre-auth forms are filled accurately and submitted on time.

2. Pre-Authorization Management

• Submit pre-authorization requests to TPAs/insurance companies promptly.
• Follow up regularly to obtain approval within required timelines.
• Maintain real-time communication with consultants regarding queries raised by TPAs.

3. Admission & Discharge Coordination

• Coordinate with admission staff for cashless approval before room allotment.
• Ensure all treatment updates and final bills are submitted to TPA before discharge.
• Process enhancement requests when treatment plan or stay extends.

4. Billing & Documentation

• Ensure all medical records, investigation reports, and bills are correct and complete.
• Maintain proper filing of TPA documents for audits.
• Provide final bill, discharge summary, and TPA-required documents before final approval.

5. TPA/Insurance Relationship Management

• Maintain updated list of TPAs, insurance companies, and empanelment guidelines.
• Build strong working relationships with TPA representatives.
• Resolve queries and escalate cases when required.

6. Communication & Customer Support

• Handle patient and family queries regarding coverage, non-payables, and approvals.
• Communicate limitations of policy, deductions, and co-pay clearly.
• Maintain a professional and supportive attitude at all times.

7. Compliance & Reporting

• Ensure compliance with hospital policies and IRDAI norms.
• Prepare daily MIS reports: pending approvals, discharged patients, claim status, deductions, and rejections.
• Assist in audits by TPA/Insurance teams.

Required Qualifications & Skills

• Education: Graduate in any discipline; preference for Hospital Administration / BBA Healthcare.
• Experience: 1–3 years in TPA desk / hospital billing / medical insurance (preferred).
• Skills:
• Strong communication & patient-handling skills
• Understanding of TPA processes
• Good typing & documentation accuracy
• Ability to work under pressure
• Computer proficiency (MS Office, HIS systems)

Key Qualities

• Pleasant, patient-centric approach
• Attention to detail
• Ethical and responsible handling of documents
• Fast learner with good coordination abilities

Salary Range

As per hospital standards and candidate experience.

Job Types: Full-time, Permanent

Pay: ₹13, ₹25,000.00 per month

Work Location: In person