Job Description

1. Educational Qualifications

Bachelor's degree in

business administration, Healthcare Management, Insurance, Finance, or related field

BBA or postgraduate diploma in Healthcare Management / Insurance preferred

2. Work Experience

Minimum 2

-3 years

' experience in hospital TPA management, health insurance, or claims processing Experience handling

TPA coordination, claim settlements, and insurance approvals

in a hospital environment Knowledge of

insurance policies, claim procedures, and regulatory guidelines

3. Core Skills & Knowledge

Managing and coordinating with TPAs for smooth claims processing Understanding of

insurance policy terms, claim documentation, pre-authorization,

and discharge approvals Monitoring and follow-up of

claim rejections, disputes, and escalations

Preparing reports on claim status, approvals, denials, and financial reconciliation

4. Technical Skills

Familiarity with Hospital Information Systems (HIS) and TPA portals Proficiency in MS Excel for data analysis and reporting Use of email and communication tools for vendor coordination

5. Communication & Negotiation Skills

Strong verbal and written communication skills for interaction with insurance companies, hospital departments, and patients Negotiation skills to resolve claim disputes and expedite approvals

6. Compliance & Documentation

Ensuring timely and accurate submission of documents as per insurance and hospital policies Maintaining audit-ready claim files and records Knowledge of healthcare regulations and insurance compliance requirements

7. Performance Indicators

Claim settlement turnaround time Reduction in claim rejection rates Accuracy and completeness of claim documentation
Job Types: Full-time, Permanent

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

Benefits:

Leave encashment Paid sick time Paid time off Provident Fund
Education:

Diploma (Preferred)
Experience:

Hospital TPA: 2 years (Preferred)
Work Location: In person