Job Description – Third Party Administrator (TPA Executive)
Company: Sat kartar Sanjeevan Hospital
Location: Paschim Vihar, Delhi
Experience: 4–6 Years
Salary: ₹30,000 – ₹40,000 per month
Job Summary:
Satkartar Sanjeevan Hospital is looking for an experienced Third Party Administrator (TPA Executive) to manage insurance and TPA operations efficiently. The ideal candidate should have hands-on experience in handling cashless approvals, insurance claims, reimbursement processes, and coordinating with insurance companies, TPAs, patients, and internal hospital departments.
Key Responsibilities
- Handle end-to-end TPA and insurance claim processes.
- Coordinate with insurance companies and TPAs for cashless approvals and claim settlements.
- Process pre-authorizations, reimbursements, and final claim submissions.
- Verify patient insurance eligibility and policy coverage.
- Ensure timely submission of all claim-related documents.
- Follow up with TPAs and insurance providers to resolve pending claims and queries.
- Coordinate with doctors, billing, admissions, and patients regarding insurance documentation.
- Maintain accurate records of approvals, rejections, and pending claims.
- Ensure compliance with hospital policies and insurance guidelines.
- Prepare daily, weekly, and monthly MIS reports related to TPA and insurance operations.
Required Skills
- Strong knowledge of TPA operations and health insurance processes.
- Experience in cashless hospitalization and reimbursement claims.
- Good understanding of hospital billing and medical documentation.
- Excellent communication and coordination skills.
- Strong analytical and problem-solving abilities.
- Proficiency in MS Excel, MS Word, and Hospital Information Systems (HIS).
Preferred Qualifications
- Bachelor's degree in any discipline.
- 4–6 years of experience in TPA/Insurance Operations within a hospital.
- Familiarity with major TPAs and health insurance companies.
Pay: ₹30,000.00 - ₹40,000.00 per month
Work Location: In person
