We are seeking an experienced and detail-oriented TPA Incharge to manage all insurance and TPA-related operations within the hospital. The candidate will be responsible for coordinating with insurance companies and TPAs, ensuring smooth cashless claim processing, minimizing claim rejections, and maintaining excellent patient service standards.
Key Responsibilities
- Handle end-to-end processing of cashless and reimbursement insurance claims.
- Coordinate with TPAs, insurance companies, and corporate clients.
- Verify patient insurance eligibility and policy coverage.
- Ensure timely submission of pre-authorizations, claim documents, and discharge approvals.
- Follow up on pending approvals and claim settlements.
- Monitor claim rejections and initiate corrective actions.
- Maintain accurate records of claims, approvals, and settlements.
- Train and supervise TPA desk staff.
- Generate periodic MIS reports related to insurance and TPA operations.
- Ensure compliance with hospital policies and insurance regulations.
- Resolve patient and insurer queries related to claims and billing.
Pay: ₹20,000.00 - ₹35,000.00 per month
Work Location: In person
