TPA INCHARGE

• Claim Management: Processing, verifying, and coordinating all aspects of cashless and reimbursement insurance claims from admission to discharge.
• Coordination: Liaising with patients, hospital staff (billing, doctors), and insurance companies/TPAs.
• Documentation: Ensuring all medical files and documents are complete, accurate, and submitted as required, managing hard copies and TPA portals.
• Authorizations: Obtaining pre-authorizations and referrals for treatments from insurers.
• Billing: Preparing split bills, updating implant bills, and reconciling with the billing department.
• Follow-up: Daily follow-ups with TPAs for claim approvals and outstanding payments.
• Compliance: Adhering to TPA, HMO, PPO, and state program guidelines and regulations.
• Reporting: Preparing monthly reports and handling post-sales service.

Essential Skills & Qualification

Graduation with relevant Experience

Job Type: Full-time

Pay: ₹30,000.00 - ₹40,000.00 per month

Work Location: In person