To manage cashless and reimbursement processes for insured patients, ensuring accurate coordination between the hospital, insurance companies, and TPAs in compliance with NABH documentation standards.
Key Responsibilities
Coordinate with TPAs/insurance companies for preauthorization and claims processing.
Verify patient insurance documents and policy eligibility before admission.
Ensure timely submission of documents for preauthorization and discharge approval.
Maintain proper documentation of patient files for audit and compliance.
Coordinate with billing, front office, and medical teams for accurate claim details.
Track claim status, manage rejections, and ensure timely reimbursements.
Prepare daily MIS reports for pending and approved cases.
Skills & Competencies
Strong understanding of health insurance and cashless systems.
Excellent documentation and coordination skills.
Proficiency in hospital billing software and MS Office.
High integrity and attention to detail.
Qualification & Experience
Graduate (preferably in Commerce or Healthcare Management).
2-4 years' experience in TPA / insurance desk in a hospital setup.
Job Type: Full-time
Pay: ?15,000.00 - ?30,000.00 per month
Benefits:
Cell phone reimbursement
Health insurance
Internet reimbursement
Leave encashment
Paid sick time
Paid time off
Provident Fund
Experience:
TPA: 1 year (Required)
Work Location: In person
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