Job Description

Position:

TPA Billing Executive

Location:

The Children's Hospital, Kachpada, Malad (West) 400064

Shift:

Rotational shifts (8 hours - Morning / Evening / Night)

Key Responsibilities

TPA & Insurance Coordination

Handle all

cashless and reimbursement insurance cases

for pediatric patients. Coordinate with

TPAs, insurance companies, and corporate clients

. Verify

insurance eligibility, coverage, and policy details

.

Pre-Authorization & Approvals

Prepare and submit

pre-authorization requests

with complete medical and billing documents. Follow up with TPAs/insurers for

timely approvals

. Coordinate with doctors, nursing staff, and medical records for required clinical documentation.

Billing & Documentation

Generate

provisional and final bills

as per approved packages and hospital tariffs. Ensure

accurate coding and billing

as per insurance norms. Maintain proper documentation for

admissions, extensions, and discharges

.

Claims Processing

Submit

final claims

within stipulated timelines. Track claim status and follow up for

payments and discrepancies

. Handle

deductions, queries, and denials

and coordinate for resolution.

Shift & Patient Desk Responsibilities

Manage TPA desk operations during

morning, evening, and night shifts

. Guide patients' families regarding

insurance procedures and documentation

. Coordinate smoothly during

emergency admissions and discharges

.

Compliance & Reporting

Ensure compliance with

hospital policies, TPA guidelines, and insurance norms

. Maintain

daily MIS reports

on admissions, approvals, discharges, and pending claims. Support

audits and internal reviews

when required.

Required Qualifications & Skills

Graduate in any discipline (

Commerce / Healthcare Management preferred

).

1-3 years of experience

in TPA billing (hospital experience preferred; pediatric exposure is a plus). Good knowledge of

insurance processes, packages, and hospital billing software

. Strong communication and coordination skills. Willingness to work in

rotational 8-hour shifts

.

Key Competencies

Attention to detail Time management Multitasking ability Patient-friendly approach Ability to work under pressure

How to Apply

Email your resume to: hr@tchm.co.in

Website:

https://www.thechildrenshospitalmumbai.com/

WhatsApp: 9653178587

(WhatsApp your resume only. No calls, please.)

Hospital Address: The Children's Hospital

, Shweta Building, New Link Road, Kanchpada, Malad West, Mumbai - 400064

Job Type: Full-time

Pay: ?15,000.00 - ?25,000.00 per month

Work Location: In person