TPA Manager

17 hours ago

Kolkata, West Bengal, India Blesswave Venture Pvt Ltd. Full time ₹ 3,00,000 - ₹ 4,80,000 per year

TPA Management:

  • Oversee the day-to-day activities of contracted TPAs.
  • Ensure adherence to SLAs, KPIs, and regulatory requirements.
  • Evaluate and monitor TPA performance through audits and reports.
  • Coordinate training and knowledge-sharing sessions with TPAs.

Claims Oversight:

  • Supervise claims adjudication, settlement, and dispute resolution.
  • Ensure timely and accurate claims processing.
  • Review complex/high-value claims and provide decision support.

Vendor Coordination:

  • Manage TPA onboarding, renewal, and contract negotiations.
  • Establish strong relationships with TPA partners to ensure smooth collaboration.

Compliance & Reporting:

  • Ensure TPA operations comply with IRDAI (for India) or local regulatory guidelines.
  • Generate reports on claims trends, fraud detection, and TPA performance.
  • Assist in internal/external audits and implement corrective measures.

Customer Experience:

  • Address and resolve escalated complaints related to TPA services.
  • Work with customer service teams to improve end-user satisfaction.

Job Type: Full-time

Pay: ₹25, ₹40,000.00 per month

Work Location: In person

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