- Verify patients' health insurance eligibility and TPA details at the time of admission.
- Process and submit cashless pre-authorization requests to TPAs/insurance companies.
- Coordinate with doctors, nursing staff, and the billing department for required medical documents.
- Follow up with TPAs and insurers for timely approval and claim settlement.
- Prepare and submit complete reimbursement and cashless claim documents.
- Resolve insurance-related queries from patients, TPAs, and insurance companies.
- Ensure all claim documentation is accurate and complies with hospital and insurance guidelines.
- Maintain records of approvals, rejections, pending claims, and payments.
- Assist patients with insurance procedures during admission and discharge.
- Prepare daily and monthly reports on TPA claims, approvals, rejections, and outstanding payments.
Experience Required
- 1–3 years of experience in hospital TPA, medical insurance, or healthcare billing operations.
- Freshers with relevant qualifications or internships in hospital administration may also be considered.
Qualification Required
- Bachelor's degree in any discipline (preferred: B.Com, BBA, or Life Sciences).
- Diploma or Bachelor's degree in Hospital Administration, Healthcare Management, or a related field is preferred.
- Knowledge of health insurance, TPA processes, cashless claims, and reimbursement procedures.
- Proficiency in Microsoft Office and Hospital Information Systems is an added advantage.
- Good communication, documentation, and coordination skills.
Pay: ₹16,000.00 - ₹30,000.00 per month
Benefits:
Work Location: In person
