Job Description

Designation: TPA Coordinator (Male)


Qualification: Graduate or Above


Department: Billing TPA


Work Experience: 2+ Years





Total Opening: 1


Location: Rajouri Garden, New Delhi

POSITION GUIDELINES

DOCUMENT- JOB DESCRIPTION/ RESPONSIBILITIES

DEPARTMENT : BILLING - T.P.A.

POSITION : COORDINATOR

REPORTING TO : MANAGER - BILLING - T.P.A.

QUALIFICATION : GRADUATION / POST GRADUATION IN COMMERCE

EXPERIENCE : 2 - 5 YEARS

DRESS CODE : SPECIFIED DRESS CODE WITH I.D. CARD

DUTY HOURS : AS PER SCHEDULED REQUIREMENTS

JOB DESCRIPTION

Key areas of responsibility:

1. To give the estimate to the patients according to the treatment advised and as per the hospital tariff.

2. To handle the Corporate Patients and make them aware regarding the authorization / approval required from their concerned companies as per the agreement with the hospital.

3. To send the Pre - Authorization request form along with the required documents to the concerned T.P.A.'s for the patients concerned under the Medical Insurance Scheme & Seeking the Cashless Transaction for their treatment.

4. To timely solve the queries raised by the T.P.A.'s in connection to the documents forwarded to them for seeking cashless transaction, in respect of the patient concerned under Medical Insurance Scheme.

5. To timely intimate the Reply / Approvals to the patients.

6. To register the date of admission of the patients & simultaneously coordinate between the Doctors & Patients in respect of their admissions.

7. To give priority to emergency cases and to co-ordinate with the consultants / respective department for the same.

8. To maintain appropriate departmental documentation.

9. To treat all communication about patients, staff, and other organizational business confidentially.

10. To be involved in quality Assurance / Quality control activities.

11. To perform all the jobs as may be assigned due to exigencies of work.

12. Participation in Continuous Quality Improvement.