Job Description – TPA Executive (Ayushman Bharat & Reception)
Position: TPA Executive (Ayushman Bharat & Reception)
Department: TPA / Front Office
Location: Hospital
Job Summary
The TPA Executive will be responsible for managing cashless insurance and Ayushman Bharat (PM-JAY) processes while also handling front office and reception responsibilities. The candidate should ensure smooth patient registration, insurance documentation, pre-authorizations, claim coordination, and provide excellent patient service.
Key ResponsibilitiesTPA & Ayushman Bharat
- Handle all TPA and cashless insurance processes.
- Manage complete Ayushman Bharat (PM-JAY) patient registration and verification.
- Verify patient eligibility on the Ayushman portal.
- Coordinate pre-authorization, approvals, and claim submissions.
- Prepare and maintain complete documentation for insurance and Ayushman cases.
- Track pending approvals, claim status, and settlements.
- Resolve TPA and Ayushman-related patient queries.
- Ensure compliance with hospital policies and government guidelines.
- Maintain records and prepare daily/monthly TPA and Ayushman reports.
Reception & Front Office
- Welcome and assist patients and visitors professionally.
- Register OPD/IPD patients and generate UHID.
- Handle appointments and patient inquiries.
- Guide patients regarding hospital services and admission procedures.
- Answer telephone calls and provide accurate information.
- Maintain reception records and patient data confidentially.
- Handle billing coordination whenever required.
Required Qualifications
- Graduate in any discipline.
Experience
- 2–5 years of experience in Hospital TPA, Ayushman Bharat (PM-JAY), and Front Office operations.
- Experience working in a multi-speciality hospital is preferred.
Required Skills
- Strong knowledge of Ayushman Bharat (PM-JAY) portal and processes.
- Good understanding of TPA, cashless claims, and medical insurance.
- Knowledge of hospital billing and documentation.
- Excellent communication and interpersonal skills.
- Proficiency in MS Office and Hospital Information System (HIS).
- Strong documentation and coordination skills.
- Good problem-solving and patient-handling abilities.
Preferred Candidate Profile
- Experience in handling Ayushman Bharat (PM-JAY), TPA, Reception, and Front Office in a hospital.
- Ability to manage multiple responsibilities efficiently while maintaining excellent patient service.
This role is ideal for a candidate who can efficiently manage Ayushman Bharat, TPA operations, insurance coordination, and reception/front office activities while ensuring a seamless patient experience.
Pay: ₹15,000.00 - ₹20,000.00 per month
Work Location: In person
