tpa coordinator

Holy Family Hospital, Bandra

Job descriptionResponsibilities:Handling the TPA Process of hospital <ul><li>Handling TPA related all process from billing to co-ordinate with TPA companies.</li><li>Responsible for counseling patient's family &amp; pre-Auth process.</li><li>Maintaining &amp; uploading patient's files on the portal.</li><li>Couriering the hard copy of patient's medical file to the Insurance companies.</li><li>Responsible for all co-ordination activities from patient's admission to discharge.</li><li>Handling billing Department, Implants bill updating &amp; reconciliation.</li><li>Daily co-ordination with the patient and Hospital staff.</li><li>Preparing split bills/ Doctor charges etc.</li><li>Handling all TPA Portals.</li><li>Outstanding follow-up with TPA.</li><li>Monthly Review report.</li><li>To obtain and review referrals and authorizations for treatments.</li><li>Must be aware of norms of the insurance sector.</li><li>Daily follow up with Insurance companies to pass or clear the Health Insurance claims.</li></ul>EducationGraduation Bcom or any stream Note: - Candidates should be from hospital background and having minimum 3 years of experience.Join our dynamic team and contribute to the communityIf you meet the above qualifications and are interested in this opportunity, please submit your resume at hr@holyfamilyhospital.in/deputyhr@holyfamilyhospital.in/hrdirector@holyfamilyhospital.in022 62670344/022 62670577Job Type: Full-timePay: &#8377;35,000.00 - &#8377;40,000.00 per monthAbility to commute/relocate:<ul><li>Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (Required)</li></ul>Work Location: In person

TPA Coordinator

Matrix Super Speciality Hospital

Job Openings at Our 50-Bed Hospital in Kharghar We are seeking experienced professionals for the following positions:1. Receptionist cum Billing AssistantSpeaking fluent English and can handle all problems for efficient functioning of hospital OPD and IPD2- TPA Coordinator (Senior) for Insurance and Empanelment3. ICU Nurse/Staff Nurse - Minimum 1year of experience in ICU nursing - Strong clinical skills and attention to detail 4. Pharmacist Minimum 1yr experience of managing pharmacy. 5. P R OExperience in Hospital Marketing6.RMOMinimum 2 yrs Experience of Handling ICU cases and ward Patients.How to Apply If you are a motivated and experienced professional looking for a new challenge, please send your CV to:Email: hr.viranshcriticarehospital@gmail.comContact Number: 7030871996We look forward to hearing from you ! &lrm;Job Types: Full-time, PermanentPay: &#8377;12,000.00 - &#8377;40,000.00 per monthWork Location: In person

Job Openings for New Multi-speciality Hospital in Kharghar

Deccan Hardikar Hospital

Contact No.- 02041095052 (HR Department)Contact Time- 10.30 AM To 5.30 PMDuty Timing-Morning, General, Evening rotational shift.Job Description <ul><li>We are looking for TPA coordinator with any graduate with min 1 to 2 years exp. in Hospital/Insurance/TPA Field/CGHS.</li><li>Handling all TPA related processes, from billing to coordinating with TPA companies.</li><li>Counselling patients and their families regarding insurance policy and billing charges.</li><li>Coordinating daily with patients and hospital staff.</li><li>Counseling patients on finances related to surgeries or procedures.</li><li>Maintaining and uploading patient files on the portal.</li><li>Preparing claim settlement documents after a patient's discharge.</li><li>Handling the billing department, updating and reconciling implants bills.</li><li>Courier hard copies of patient admission to discharge.</li><li>Following up withTPA's for approval and informing patients and their relatives of the status.</li><li>Following and adhering to all regulationsand guidelines set by insurance company.</li><li>Ability to operate with a high level of confidentiality and prossionalism.</li><li>maintain and updating all departmental registers.</li><li>Reporting to the HOD and assisting with administrative tasks.</li></ul>Required Skills<ul><li>Claims Management</li><li>Patient service</li><li>Team leadership</li><li>Quality assurance</li><li>Written and oral communication</li><li>Problem solving</li><li>Multitask</li><li>Good communication</li><li>Time Management</li></ul>Job Type: Full-timePay: &#8377;16,000.00 - &#8377;25,000.00 per monthBenefits:<ul><li>Flexible schedule</li><li>Paid sick time</li><li>Paid time off</li></ul>Application Question(s):<ul><li>What is your Current Salary?</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Experience:<ul><li>TPA Billing Executive: 2 years (Preferred)</li></ul>Work Location: In person

TPA Billing Executive

Malar Hospitals

Job Title: Insurance ExecutiveDepartment: Billing &amp; Insurance Location: Malar Hospital, Hosur Reporting To: Billing Manager / Hospital AdministratorJob Summary:The Insurance Executive is responsible for handling all activities related to insurance claims, pre-authorization, documentation, billing coordination, and liaising with TPAs (Third Party Administrators) to ensure smooth processing of patient insurance cases.Key Responsibilities:<ul><li>Coordinate with patients for insurance-related documents at the time of admission and discharge.</li><li>Process pre-authorization requests by preparing and submitting necessary documents to insurance/TPA companies.</li><li>Ensure timely follow-up and approvals for cashless treatment.</li><li>Verify policy coverage, eligibility, and limits before raising claims.</li><li>Maintain accurate and updated insurance files for all patients under insurance.</li><li>Coordinate with treating doctors and departments for final bill approval.</li><li>Raise final claim forms, discharge summaries, and other required documents.</li><li>Liaise with TPA companies and insurance providers for claim status and settlement.</li><li>Ensure all claim-related queries and discrepancies are addressed promptly.</li><li>Submit insurance reports to the management on a daily/weekly/monthly basis.</li><li>Ensure compliance with all regulatory requirements related to insurance billing.</li><li>Assist patients and families with insurance-related queries and counseling.</li></ul>Qualifications:<ul><li>Graduate in any discipline (B.Com, BBA preferred).</li><li>Diploma or certification in Hospital Administration / Medical Insurance is an advantage.</li><li>Minimum 1&ndash;2 years of experience in hospital insurance billing / TPA coordination.</li></ul>Skills Required:<ul><li>Strong knowledge of health insurance processes and TPA policies.</li><li>Good communication and interpersonal skills (Tamil and English preferred).</li><li>Attention to detail and accuracy in documentation.</li><li>Basic knowledge of hospital billing software and MS Office.</li><li>Ability to handle patient queries calmly and professionally.</li></ul>Regards,HR Departmenthr@malarhospitals.com8870166133Malar Hospital,HosurJob Types: Full-time, PermanentPay: &#8377;15,000.00 - &#8377;25,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

hospital Insurance Executive

UJALA CYGNUS RAINBOW HOSPITAL, AGRA

1. TPA &amp; Insurance Coordination<ul><li>Act as the primary liaison between the hospital and all empaneled TPAs and insurance companies.</li><li>Ensure all documentation required for cashless and reimbursement claims is complete and submitted on time.</li></ul>2. Cashless Authorization<ul><li>Facilitate the process of obtaining pre-authorization approvals for cashless treatments.</li><li>Monitor turnaround time for approval and escalate delays as necessary.</li><li>Coordinate with doctors and departments for timely medical information required by TPAs.</li></ul>3. Claims Processing &amp; Documentation<ul><li>Oversee preparation and submission of final bills and discharge summaries to TPAs.</li><li>Ensure all claims are submitted accurately with complete supporting documents.</li><li>Monitor the status of submitted claims and follow up regularly until settlement.</li></ul>4. Reimbursement Follow-ups<ul><li>Track claim rejections or short payments.</li><li>Reconcile accounts and resubmit or appeal denied claims with justifications.</li><li>Maintain communication with patients about the status of their insurance claims.</li></ul>5. Empanelment &amp; TPA Agreements<ul><li>Manage TPA empanelment processes and documentation.</li><li>Review and renew contracts with TPAs and insurance companies as needed.</li></ul>6. MIS &amp; Reporting<ul><li>Maintain updated records of all cashless and reimbursement claims.</li><li>Generate daily/weekly/monthly reports on claim status, approvals, rejections, and payments received.</li><li>Analyze data to identify bottlenecks or trends in claim rejections.</li></ul>7. Team Management<ul><li>Supervise and train the TPA desk staff.</li><li>Allocate duties, monitor performance, and ensure quality service.</li></ul>8. Patient Support &amp; Counselling<ul><li>Educate patients about their insurance policies, entitlements, and the claim process.</li><li>Assist patients in completing necessary paperwork.</li><li>Address grievances related to delays or denials of claims.</li></ul>9. Compliance &amp; Audit<ul><li>Ensure compliance with IRDAI guidelines and other regulatory requirements.</li><li>Prepare for audits by TPAs or insurance companies and respond to audit queries.</li></ul>10. Coordination with Internal Departments<ul><li>Work closely with billing, admission, discharge, and medical records departments.</li><li>Ensure seamless flow of information for cashless and reimbursement processing.</li></ul>Job Type: Full-timePay: &#8377;20,000.00 - &#8377;50,000.00 per monthBenefits:<ul><li>Cell phone reimbursement</li><li>Paid sick time</li><li>Provident Fund</li></ul>Work Location: In person

Credit / TPA MANAGER

Chaitanya eye Hospital and Research Center

Qualification MSW/Bsc/Degre/BBAPreffered -Hospital experienced female candidateBenifits -Free hostel facility providedResponsibilities: <ul><li>Provide escort services to patients on program transportation.</li><li>Transport/ escort patients to appointments and remain with them.</li><li>Provides personal care assistance.</li><li>Provides assistance to the activity programs.</li><li>Functions as a member of a multi-disciplinary team.</li><li>Reminder Calls on confirmed appointments for the same day.</li><li>Helping patients to avail discounts at the Help desk and get billed his invoice from the respective billing counter.</li></ul>After billing, escort the patients to the doctors' floor and speak with the coordinator. Helping them in diagnostic if advised by Doctors Escorting the patient for admission and discharged for cash patients and TPA Patients For cash Patients, RFA (Request for admission) will be provided to the patient by the doctors' coordinator with stamped<ul><li>If a patient has insurance RFA will be provided by the doctor coordinator with cost estimation patient has to deposit the documents with a registered office of TPA within 48 hrs</li><li>After everything is done we provide our contact numbers for any further help in a hospital</li><li>Helping to find the IPDs for same-day cases recon from respective floors</li><li>Interacting with Doctors, coordinators, and billing staff on respective floors and taking the feedbacks on the daily basis</li></ul>For International Admissions : - Calling the patient and informing them about the Help desk and location. An International patient visits our desk or we receive from the main Porch.<ul><li>We visit IPS (International Patient Services) for registration and mapping under mfine</li><li>After Registration, we escort the patient to the appropriate floor</li><li>Escort in Radiology department, sample collection if advised by the doctor</li><li>Helping in admission from IPS(International Patient Services)</li><li>After everything is done, drop the international patient at the main porch</li></ul>Job Type: Full-timePay: &#8377;15,000.00 - &#8377;18,000.00 per monthBenefits:<ul><li>Flexible schedule</li><li>Health insurance</li><li>Leave encashment</li><li>Paid time off</li><li>Provident Fund</li></ul>Ability to commute/relocate:<ul><li>Kesavadasapuram, Thiruvananthapuram, Kerala: Reliably commute or planning to relocate before starting work (Preferred)</li></ul>Experience:<ul><li>total work: 3 years (Required)</li></ul>Work Location: In person

Patient Care Coordinator

HealthCare Global Enterprises Ltd

Job Title: Billing Executive &ndash; Credit &amp; TPADepartment: Billing / Finance Location: HCG Hospital Open Positions: 3 Experience Required: 2 &ndash; 6 years Joining: ImmediateAbout HCG Hospital:HCG (Healthcare Global Enterprises Ltd.) is India&rsquo;s largest provider of cancer care and a leading network of multi-specialty hospitals committed to delivering high-quality healthcare services with compassion and innovation. We are looking for dynamic professionals to join our team and contribute to our mission of delivering excellence in patient care.Role Overview:The Billing Executive &ndash; Credit &amp; TPA will be responsible for managing and processing billing activities related to credit and third-party administrators (TPA). The role requires accuracy, attention to detail, and a thorough understanding of hospital billing and insurance processes.Key Responsibilities:<ul><li>Prepare, verify, and process patient bills under credit and TPA categories.</li><li>Coordinate with TPA desks, insurance companies, and corporate clients for approvals and settlements.</li><li>Ensure timely submission of claims and follow-up for outstanding payments.</li><li>Handle pre-authorization, approval, and disbursement processes as per TPA norms.</li><li>Reconcile billing discrepancies and address patient or client queries promptly.</li><li>Maintain accurate billing records and support internal and external audits.</li><li>Liaise with the finance and accounts team for proper posting and closure of bills.</li><li>Ensure compliance with hospital policies, statutory requirements, and billing standards.</li></ul>Required Qualifications &amp; Skills:<ul><li>Bachelor&rsquo;s degree in Commerce, Finance, Hospital Administration, or a related field.</li><li>2&ndash;6 years of experience in hospital billing, preferably handling Credit &amp; TPA operations.</li><li>Strong knowledge of insurance processes, claim management, and billing systems.</li><li>Proficient in hospital information systems (HIS) and MS Office.</li><li>Excellent communication, coordination, and problem-solving skills.</li><li>Ability to work under pressure and meet timelines.</li></ul>Job Types: Full-time, PermanentPay: &#8377;16,000.00 - &#8377;28,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Leave encashment</li><li>Paid sick time</li><li>Paid time off</li><li>Provident Fund</li></ul>Work Location: In person

Executive - Billing

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