Job Description

Designation: TPA Executive


Qualification: Graduate or Above


Department: TPA


Work Experience: 2+ Years





Total Opening: 1


Location: Pitampura, New Delhi

POSITION GUIDELINES

DOCUMENT- JOB DESCRIPTION/ RESPONSIBILITIES

DEPARTMENT : T.P.A.

POSITION : EXECUTIVE/ COORDINATOR

REPORTING TO : MANAGER

QUALIFICATION : GRADUATION / POST GRADUATION IN COMMERCE

EXPERIENCE : 1 - 5 YEARS

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

DUTY HOURS : AS PER SCHEDULED REQUIREMENTS

JOB DESCRIPTION

Key areas of responsibility:

Responsible for handling TPA Empanelment.
Ensure that entire billing part and documentation part is as per requirement.
TPA/Cashless /ECHS /CGHS /ESIC billing & documentation.
Liaison with Govt. Health Departments.
Liaison with Insurance Companies
Tie ups with Corporate Houses.
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.
To give priority to emergency cases and to co-ordinate with the consultants / respective department for the same.
To maintain appropriate departmental documentation.
To treat all communication about patients, staff, and other organizational business confidentially.
To be involved in quality Assurance / Quality control activities.
To perform all the jobs as may be assigned due to exigencies of work.
Participation in Continuous Quality Improvement.
Ensure invoice is done without any delay.
Also, need to ensure that the Invoice is submitted to the respective payers on time.
Payment follow up religiously and ensure that the DSO is maintained as per the credit terms signed during empanelment