Job Description

Qualification:

Any graduation with good speaking skills and MS Excel ,MS Word

Experience:

Having 3 years of hands on working experience in TPA

:

1. Processing of Preauthorization Letter & Authorization letter

2. Check Insurance card, when patient approaches IP desk for admission.

3. Tie up with desired TPA is checked from the FO Info file.

4. Mailing preauthorization form duly filled with copy of Insurance card to the TPA.

5. Follow up for authorization letter and updating the patient and the doctor about it.

6. Coordinate to give replies to queries of TPA / Corporate (if any).

7. Admit the patient as cash patient incase of denial of auth LETTER. (See the IPD admission &

Discharge Process).

8. Entry is made in Front Office Executive File.

9. Patient treatment starts (Nursing & Doctor Process).

10. Follow up treatment on the line of Authorization letter.

11. Review Bed status with approved amount on daily basis and inform TPA in case of any

variance.

12. Follow up for new authorization form in case of change in line of treatment.

13. Preparing the Final bill for the discharge.

14. Check Pre-auth, auth & Discharge Summary to avoid any discrepancy.

15. Check particulars of the patient on all the documents.

16. Collect cash for all non-medical & non covered items from the patient.

17. Get the signature of the patient on the final bill.

18. Dispatching the bill.

19. Original Discharge Bill, Pharmacy break up, Authorization letter, all reports in original, copy

of patient ID card are collated and verified by the PCE.

20. Prepare 2 sets of all the papers and send it to accounts.

21. Accounts prepares Covering letter and dispatches the original set to the TPA.

22. Update Front Office Executive file with details.

Job Type: Full-time

Work Location: In person