Need a TPA person for Multi-speciality hospital

3 days ago

Pune, Maharashtra, India Medico Hub Full time ₹ 2,00,000 - ₹ 6,00,000 per year

Contact Mr Nishant Chaudhary WhatsApp

Industry & Sector: Healthcare — Multi-speciality hospital delivering inpatient and outpatient clinical services, surgical care and allied diagnostics in the Pune (Talegaon) region. This on-site role supports hospital revenue-cycle operations and insurer/TPA relationships to ensure seamless patient admission and claim settlement.

Primary job title: TPA Coordinator

About the Opportunity

We are hiring an experienced TPA Coordinator to join a multi-speciality hospital in Talegaon, Pune (Maharashtra). The role is fully on-site and focuses on managing third-party administrator (TPA) interactions, processing cashless and reimbursement claims, and ensuring timely claim settlements while maintaining clinical and billing compliance.

Role & Responsibilities
  • Act as the primary liaison with TPAs and insurance providers for cashless admissions, pre-authorisations and claim settlements.
  • Verify patient insurance coverage, validate documentation and complete pre-authorization workflows within TPA portals.
  • Coordinate with clinical teams and billing department to compile claim dossiers, submit final bills and follow up for settlement.
  • Manage claim follow-ups, chase outstanding payments, and resolve discrepancies or denials with evidence-based appeals.
  • Maintain accurate records of authorisations, claim statuses and communications; escalate unresolved cases to management.
  • Support process improvements for faster claim turnaround and collaborate on audit readiness and compliance checks.
Skills & Qualifications

Must-Have

  • Graduate or diploma holder with proven experience in hospital TPA operations
  • Hands-on experience with cashless authorisation and pre-authorization processes
  • Demonstrable knowledge of medical billing and claim settlement workflows
  • Experience using TPA portals and managing end-to-end claim submissions
  • Strong tracking and documentation skills; ability to manage multiple active claims
  • Willingness to work on-site at Talegaon, Pune

Preferred

  • Prior experience in a multi-speciality hospital setting
  • Familiarity with Hospital Information Systems (HIS) or EHR platforms
  • Proficiency in Marathi/Hindi and English for local TPA and patient interactions
Benefits & Culture Highlights
  • Stable on-site role within a multi-speciality hospital with direct impact on patient experience and revenue cycle.
  • Opportunity to work cross-functionally with clinical, billing and admin teams and grow into senior RCM/TPA roles.
  • Competitive compensation aligned with experience and local market standards (Talegaon, Pune).

To apply, candidates based in or near Talegaon/Pune with demonstrated TPA and hospital billing experience are encouraged to submit their resume and a brief summary of prior TPA workflows managed.

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