TPA Executive

Job Title: TPA Executive

Department: Billing
Reporting To: Billing Manager

Job Responsibilities:

• Coordinate with TPAs and insurance companies for cashless hospitalization cases.
• Collect, verify, and submit all required documents for pre-authorization and final claims.
• Ensure timely approval of pre-auth and follow up for pending cases.
• Prepare and submit final bills, discharge summaries, and supporting medical documents.
• Regularly follow up with TPAs/insurance companies for claim settlement.
• Resolve queries, discrepancies, and rejections raised by TPAs.
• Maintain proper records of cashless and reimbursement cases.
• Update patients and attendants regarding claim status and requirements.
• Coordinate with doctors, nursing staff, billing, and accounts departments.
• Ensure compliance with hospital policies and TPA guidelines.
• Prepare daily/monthly TPA MIS and reports.

Eligibility & Skills:

• Graduate in any discipline (Healthcare / Hospital Management preferred).
• 1–3 years experience in hospital TPA / insurance desk.
• Knowledge of medical terminology, ICD codes, and billing processes.
• Familiar with cashless & reimbursement claim procedures.
• Good communication and coordination skills.
• Proficient in MS Office and Hospital Information Systems (HIS).

Key Competencies:

• Attention to detail
• Time management
• Patient handling
• Problem-solving skills

Work Location: Hospital / Healthcare Facility

Shift: Morning/Evening/Night/ Rotational (as per hospital requirement)

Job Types: Full-time, Permanent

Pay: ₹15,000.00 - ₹20,000.00 per month

Work Location: In person