Job Description

Handle

cashless hospitalization processes

for all TPA & insurance patients Verify

insurance eligibility, policy coverage, and pre-authorization requirements

Prepare and submit

pre-authorization requests

within defined TAT Coordinate with doctors, nursing staff, and billing team for

treatment details & estimates

Follow up with TPAs/insurance companies for

approval, enhancement, and clarifications

Maintain accurate documentation including: Admission notes Treatment sheets Investigation reports Discharge summaries Prepare and submit

final bills and claim documents

within stipulated timelines Track

claim status

and ensure timely settlement Handle

query management, deductions, and justifications

raised by TPAs Maintain

daily MIS reports

of admissions, approvals, discharges, and pending claims Coordinate for

rejections, short payments, and appeals

Ensure compliance with

IRDA, hospital policies, and TPA guidelines

Provide

patient counselling

regarding insurance process, exclusions, and co-payment Maintain confidentiality of

patient and financial data

Key Skills & Competencies

Strong knowledge of

TPA & Health Insurance processes

Understanding of

medical terminology and billing codes

Excellent

communication and coordination skills

Ability to work under

pressure and strict timelines

Good documentation and

follow-up skills

Proficiency in

HIS, MS Excel, and hospital billing software

Educational Qualification

Graduate in any discipline (B.Com / BBA / BA preferred) Certification in

Medical Billing / TPA Operations

(added advantage)

Experience

5-7 years

of experience as a

TPA Executive / Insurance Coordinator

in a hospital
Job Types: Full-time, Permanent

Pay: ?20,000.00 - ?35,000.00 per month

Experience:

tpa: 4 years (Required)
Work Location: In person