Hospital- Purnima Netralaya
Location- Tamolia, Jamshedpur
Position- COUNSELOR CUM TPA CO-ORDINATOR
ROLES & RESPONSIBILITIES:
A.
- Patient Counselling Responsibilities:
- Counsel patients and attendants regarding treatment procedures, surgery packages, and estimated expenses.
- Explain cashless and reimbursement processes clearly.
- Provide clarity on insurance coverage, exclusions, co-pay, and non-payable items.
- Address patient queries politely and professionally.
- Ensure informed financial consent prior to admission/surgery.
- Coordinate with doctors and OT scheduling team for planned procedures.
- Update management regarding pending approvals and outstanding claims.
- Maintain proper filing and documentation (physical and digital).
- Maintain confidentiality of patient and insurance data.
B.
- TPA & Insurance Coordination:
- Coordinate with TPAs, insurance companies, and corporate panels for pre-authorization and claim approvals.
- Prepare and submit pre-authorization forms with complete documentation.
- Ensure timely follow-up for approvals, query responses, and claim settlements.
- Maintain accurate records of all TPA cases (cashless & reimbursement).
- Verify policy details, eligibility, and coverage limits before admission.
- Coordinate with billing, medical records, and clinical departments for claim-related documentation.
- Handle claim rejections, deductions, and resubmissions effectively.
- Verifying for approvals and claim submissions.
Interested candidates can share their resume on [email protected]
Pay: ₹20,000.00 - ₹35,000.00 per month
Work Location: In person
