Job Description

A TPA (Third Party Administrator) job in a hospital involves acting as a liaison between patients, hospitals, and insurance companies to process claims, manage health insurance policies, and resolve billing issues.

Key Responsibilities

Claim Management: Coordinate the end-to-end TPA process for insurance claims, from patient admission to discharge, ensuring accurate documentation and billing. Insurance Verification: Review and verify patient health insurance coverage, eligibility, and policy benefits to ensure claims are processed within scope. Liaison with Insurers: Act as the hospital's representative to interact with insurance companies and their TPAs, following up to clear claims and authorize treatments. Patient Support: Guide patients on insurance processes, explain policy inclusions/exclusions, and provide information on claim status and reimbursement procedures. Documentation & Records: Maintain accurate records of all patient and stakeholder interactions and process patient claims, ensuring the correct submission of information and documentation. Portal Management: Handle and manage TPA online portals, which are used for submitting and tracking claims and other related transactions. Reconciliation: Update and reconcile implant bills to ensure accurate financial records. Reporting: Prepare and share regular reports, including MIS (Management Information System) reports, to inform management about TPA operations.
Job Types: Full-time, Fresher

Pay: ₹18,000.00 - ₹25,000.00 per month

Benefits:

Health insurance Provident Fund
Education:

Bachelor's (Preferred)
Experience:

TPA: 1 year (Preferred)
Language:

English (Preferred)
Work Location: In person