We are seeking a detail-oriented and organized TPA Executive to manage all third-party insurance processes within the hospital. The role involves coordinating between patients, insurance companies, and internal departments to ensure timely and accurate processing of pre-authorizations, approvals, claims, and reimbursements.
Key Responsibilities:
TPA Coordination:
Handle daily operations related to Third-Party Administrators (insurance companies, corporates, and government schemes).
Ensure timely submission of pre-authorization requests and follow up on approvals.
Act as the liaison between hospital departments and TPA
Documentation & Records:
Verify and maintain accurate records of patient insurance documents.
Ensure completeness of documentation for claim submission.
Prepare and submit final bills to TPAs for reimbursement.
Claims Management:
Monitor claim statuses and follow up on pending or rejected claims.
Coordinate with finance/accounts for reconciliations and payment updates.
Maintain a database of all claims submitted and their status.
Patient Interaction:
Guide insured patients regarding TPA formalities and requirements.
Provide assistance during admission and discharge regarding insurance processing.
Compliance & Reporting:
Ensure compliance with all insurance policies and procedures.
Generate periodic MIS reports and submit to management.
Qualifications:
Graduate in any discipline
1-3 years of experience in hospital TPA operations or health insurance claims
Knowledge of hospital billing software and TPA portals
Why Join Us:
G Plus Heart Hospital & Vascular Intervention Center
, located in Kalyan West, is a multi-super specialty hospital offering a range of cardiac and other specialized services. They focus on providing world-class cardiac care and have a dedicated cardiology department with experienced doctors. The hospital also offers neurosurgery, urological surgery, nephrology, oncological surgery, orthopedic surgery, and general and laparoscopic surgery.
9076206000 / hr@gpluskalyan.com
Job Type: Full-time
Pay: ?25,000.00 - ?40,000.00 per month
Benefits:
Cell phone reimbursement
Health insurance
Paid sick time
Paid time off
Work Location: In person
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