We are looking for an experienced and detail-oriented TPA / Billing Executive to handle hospital billing operations and Third Party Administrator (TPA) processes. The candidate should have sound knowledge of medical insurance, pre-authorization, and claim settlements.
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Key Responsibilities
Manage patient billing - cash, credit, and insurance cases.
Coordinate with TPA/Insurance companies for pre-authorization, approvals, and final claim settlements.
Prepare and verify patient bills, ensuring accuracy and compliance with hospital and insurance policies.
Maintain complete documentation for TPA and insurance claims.
Follow up with insurance/TPA providers for pending claims and ensure timely reimbursements.
Address and resolve patient queries related to billing and insurance.
Support finance and audit teams with reconciliations and reports.
Ensure adherence to hospital SOPs, statutory compliance, and audit requirements.
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Qualifications & Skills
Graduate in Commerce, Healthcare Administration, or equivalent.
1-3 years of experience in hospital billing / TPA coordination.
Strong knowledge of medical insurance and TPA claim processes.
Proficiency in MS Office and hospital billing software (HMS).
Good communication, negotiation, and follow-up skills.
Ability to multitask, work under pressure, and maintain accuracy.
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Salary & Benefits
Salary: Competitive (based on experience).
Health insurance & medical benefits.
Growth opportunities and skill enhancement training.
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