TPA Executive
Location: Kalyani, West Bengal
Job Type: Full-time, Permanent
Salary: ₹10,000 – ₹16,000 per month
Job Summary
We are looking for a motivated and detail-oriented TPA Executive to join our hospital team in Kalyani. The ideal candidate should have experience in hospital TPA operations, medical insurance coordination, and claim processing. The role involves coordinating with insurance companies, Third-Party Administrators (TPAs), patients, and internal departments to ensure smooth cashless approvals and timely claim settlements.
Key Responsibilities
- Coordinate with TPAs and insurance companies for cashless and reimbursement claims.
- Process pre-authorisation requests for planned and emergency hospital admissions.
- Assist patients and their attendants with insurance-related procedures and documentation.
- Verify insurance policies, eligibility, and required documents.
- Prepare, review, and submit claim documents accurately and within timelines.
- Follow up with TPAs regarding claim approvals, deficiencies, and settlements.
- Resolve insurance-related queries from patients and TPAs.
- Maintain accurate records of approvals, claims, settlements, and pending cases.
- Coordinate with Billing, Admission, Discharge, Medical Records, and Finance departments for seamless claim processing.
- Ensure compliance with hospital policies, insurance guidelines, and regulatory requirements.
Required Skills
- Good communication and interpersonal skills.
- Strong documentation and organizational skills.
- Basic knowledge of hospital billing and medical insurance procedures.
- Proficiency in MS Office and Hospital Management Software (HMS).
- Ability to work under pressure and manage multiple tasks efficiently.
- Strong attention to detail and problem-solving skills.
Qualifications
- Bachelor's degree in any discipline.
- Degree or certification in Healthcare Management will be an added advantage.
Experience
- Minimum 2 year of experience in a hospital TPA, medical insurance, or healthcare claims role.
- Experience handling cashless insurance approvals and TPA coordination is preferred.
Benefits
- Provident Fund (PF)
- Paid Leave as per company policy
- Professional and supportive work environment
- Career growth opportunities
Job Details
- Schedule: Shifting
- Work Location: In-person (Kalyani, West Bengal)
Preferred Candidate
- Immediate joiners are preferred.
- Candidates residing in or willing to relocate to Kalyani or nearby areas will be given preference.
Apply today and become a part of a healthcare team committed to delivering quality patient care through efficient insurance and TPA coordination.
Pay: ₹10,020.02 - ₹15,528.45 per month
Benefits:
- Flexible schedule
- Provident Fund
Ability to commute/relocate:
- Kalyani, West Bengal (Kalyani, Nadia District): Reliably commute or planning to relocate before starting work (Preferred)
Experience:
Shift availability:
- Day Shift (Preferred)
- Night Shift (Preferred)
- Overnight Shift (Preferred)
Work Location: In person
