A Hospital is looking for a dedicated and detail-oriented
TPA Coordinator
to join the team. The TPA Coordinator will be responsible for managing the interaction between the hospital and third-party administrators, ensuring smooth processing of insurance claims, and providing support to patients throughout the insurance verification and claim process. This is a full-time position based at our Khanda Colony, Panvel branch.
Key Responsibilities:
Insurance Verification:
Coordinate with insurance companies and third-party administrators to verify patient insurance details, coverage, and eligibility.
Claims Processing:
Handle all aspects of claim processing, including documentation, submission of claims, and follow-up to ensure timely settlement of claims.
Patient Assistance:
Assist patients in understanding their insurance coverage and guide them through the pre-authorization process.
Data Management:
Maintain accurate records of insurance claims, approvals, and denials. Ensure all relevant documentation is available and updated in the system.
Coordination with Hospital Departments:
Collaborate with various hospital departments to gather necessary information for insurance claims and approvals.
Pre-Authorization:
Ensure pre-authorization requests are processed for surgeries, procedures, and hospital admissions as per insurance guidelines.
Billing Support:
Work closely with the billing department to resolve any discrepancies between hospital charges and insurance reimbursements.
Follow-Up:
Follow up with insurance companies regarding pending claims and payment status, ensuring timely resolution.
Customer Service:
Provide excellent service to patients and their families, addressing queries regarding insurance-related matters and resolving any issues that may arise.
Qualifications & Skills:
Education:
Graduate in any stream; a background in healthcare administration or insurance is a plus.
Experience:
Prior experience in TPA or insurance coordination in a hospital or healthcare setting is preferred.
Skills:
Strong communication skills (both verbal and written).
Good organizational skills with attention to detail.
Ability to work under pressure and meet deadlines.
Basic knowledge of health insurance policies, procedures, and claim settlement processes.
Proficiency in MS Office (Word, Excel) and hospital management software.
Ability to handle sensitive patient information with confidentiality.
Additional Requirements:
Positive attitude and willingness to work in a team-oriented environment.
Ability to work flexible hours when necessary, including weekends and holidays.
Basic understanding of medical terminology is a plus.
Benefits:
Opportunity to work with a leading hospital in the Panvel region.
Learning and development opportunities in the healthcare and insurance sector.
How to Apply:
Interested candidates are invited to send their resume to hrmartechsimplified@gmail.com or call at 9873977672.
Job Type: Full-time
Pay: ₹15,000.00 - ₹20,000.00 per month
Work Location: In person
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