Qureos Mentor

Acharya Shri Nanesh Hospital

<ul><li>Job Summary: Manage TPA (Third Party Administrator) operations, ensuring efficient processing of health claims. Coordinate with healthcare providers, insurers, and customers to resolve claim-related issues. Analyze data to identify trends and areas for improvement in the claims process.</li></ul>Responsibilities<ul><li>Coordinate with healthcare providers, insurance companies, and patients to resolve claims-related issues.</li></ul><ul><li>Process patient claims from admission to discharge, ensuring accurate and timely payment.</li></ul><ul><li>Manage TPA (Third Party Administrator) activities, including claim settlements and reconciliations.</li></ul><ul><li>Maintain CRM (Customer Relationship Management) software to track customer interactions and updates.</li></ul><ul><li>Ensure compliance with regulatory requirements for medical insurance policies. Handling TPA related all process from billing to co-ordinate with TPA companies.</li></ul><ul><li>Responsible for counselling patient's family &amp; pre-Auth process.</li></ul><ul><li>Maintaining &amp; uploading patient's files on the portal.</li></ul><ul><li>Couriering the hard copy of patient's medical file to the Insurance companies.</li></ul><ul><li>Responsible for all co-ordination activities from patient's admission to discharge.</li></ul><ul><li>Handling billing Department, Implants bill updating &amp; reconciliation.</li></ul><ul><li>Daily co-ordination with the patient and Hospital staff.</li></ul><ul><li>Preparing split bills/ Doctor charges etc.</li></ul><ul><li>Handling all TPA Portals.</li></ul><ul><li>Outstanding follow-up with TPA.</li></ul><ul><li>Monthly Review report.</li></ul><ul><li>To obtain and review referrals and authorizations for treatments.</li></ul><ul><li>To follow and adhere to all regulations and guidelines set by state programs, and HMO/PPO, etc.</li></ul><ul><li>Must be aware of norms of the insurance sector.</li></ul><ul><li>Daily follow up with Insurance companies to pass or clear the Health Insurance claims.</li></ul>Job Types: Full-time, Permanent, FresherPay: &#8377;27,127.64 - &#8377;30,681.51 per monthBenefits:<ul><li>Leave encashment</li><li>Provident Fund</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Work Location: In person

TPA Executive

<ul><li>provide healthcare services to patients in hospitals, nursing homes, and other medical facilities.</li><li>Patient care: provide basic patient care, including bathing, dressing, and feeding patients. They also help patients with activities of daily living, such as using the toilet.</li><li>Medication: administer medications and injections as prescribed by doctors.</li><li>Vital signs: monitor patients' vital signs, such as temperature, blood pressure, and respiration rate. They report any significant changes to the medical team.</li><li>Education: educate patients and their families about health conditions and self-care techniques.</li><li>Medical records: maintain accurate and updated medical records for each patient.</li><li>Infection control: adhere to infection control protocols and maintain a clean and safe environment for patients.</li><li>Emergency care: provide emergency health care and treatment to minor ailments.</li><li>Surgeries: help with surgeries.</li><li>Emotional support: provide emotional support to patients and their families.</li></ul>Job Types: Full-time, Permanent, FresherPay: &#8377;26,000.00 - &#8377;32,000.00 per monthBenefits:<ul><li>Food provided</li><li>Leave encashment</li><li>Paid sick time</li><li>Provident Fund</li></ul>Ability to commute/relocate:<ul><li>CBD Belapur, Navi Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (Required)</li></ul>License/Certification:<ul><li>REGISTATION (Required)</li></ul>Work Location: In person

Staff Nurse (ICU)

Join Acharya Shri Nanesh Hospital and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Acharya Shri Nanesh Hospital

ABOUT_COMPANY

TPA Executive

Staff Nurse (ICU)