TPA Coordinator (Hospital Insurance Desk)Organization
Location: Women Pride Hospital & IVF, Rewari, Haryana
Job Type: Full Time
Experience Required: 1–5 Years (Hospital TPA / Insurance Experience Preferred)
Salary: As per experience and interview performance
Job Summary
Women Pride Hospital & IVF is looking for a dedicated TPA Coordinator to manage cashless insurance approvals, patient coordination, claim documentation, and liaison with insurance companies and TPAs.
The candidate will be responsible for ensuring smooth processing of cashless and reimbursement cases while maintaining compliance and timely documentation.
Key ResponsibilitiesTPA & Insurance Coordination
- Handle all cashless and reimbursement cases.
- Coordinate with TPAs, insurance companies, and corporate clients.
- Submit pre-authorization requests and obtain approvals.
- Follow up for pending approvals and claim settlements.
- Manage enhancement requests and discharge approvals.
Documentation
- Verify patient documents and insurance eligibility.
- Prepare and submit claim files as per TPA requirements.
- Maintain accurate records of approvals, denials, and settlements.
- Ensure proper documentation for audits and compliance.
Patient Coordination
- Explain insurance processes to patients and attendants.
- Assist patients regarding cashless approvals and reimbursement procedures.
- Coordinate with billing, nursing, doctors, and front office teams.
Billing & Claims
- Reconcile approved and billed amounts.
- Track outstanding claims and payments.
- Coordinate with accounts department for claim settlements.
- Maintain daily MIS and TPA reports.
Reporting
- Daily TPA case status report.
- Pending approval report.
- Claim settlement and rejection analysis.
- Monthly TPA revenue report.
Required Skills
- Knowledge of TPA and health insurance processes.
- Familiarity with hospital billing systems.
- Good communication and patient handling skills.
- Strong documentation and follow-up abilities.
- Basic computer skills (MS Excel, Email, Hospital Software).
Preferred Qualification
- Graduate in any discipline.
- Experience in hospital TPA/Insurance department preferred.
- Experience with NABH-accredited hospitals will be an added advantage.
Benefits
- Professional growth opportunity.
- Friendly work environment.
- Exposure to NABH-accredited hospital operations.
- Performance-based incentives.
Apply Now
Women Pride Hospital & IVF
Rewari, Haryana
Pay: ₹15,000.00 - ₹34,887.28 per month
Work Location: In person
