Hiring: TPA Manager
Experience: 3-5 years
Employment Type: Full-time
We are looking for an experienced and result-oriented TPA Manager to manage third-party administrator operations, ensure smooth coordination with TPAs, and drive timely resolution of claims and service-related issues.
Key ResponsibilitieS
Manage day-to-day coordination with TPAs, insurance companies, hospitals, and internal teams.
Monitor claims processing, approvals, settlements, and pending cases.
Ensure timely resolution of escalations, queries, and customer complaints.
Track TPA performance against agreed SLAs and identify areas for improvement.
Review MIS, claim trends, turnaround times, and operational performance.
Coordinate with TPAs and insurers for cashless approvals, reimbursements, and claim-related issues.
Ensure compliance with company policies, insurance guidelines, and applicable regulations.
Develop strong relationships with key TPA and insurance partners.
Identify process gaps and implement measures to improve efficiency and customer experience.
Lead and mentor the TPA/claims operations team.
Candidate Profile
Graduate/MBA preferred; relevant insurance or healthcare qualification will be an advantage.
3-5 years of experience in TPA, health insurance, claims, healthcare administration, or insurance operations.
Strong knowledge of health insurance claims and TPA processes.
Excellent communication, negotiation, coordination, and problem-solving skills.
Good analytical and MIS-reporting capabilities.
Ability to manage multiple stakeholders and work under deadlines.
Proficiency in MS Excel and other relevant operational tools.
CONTACT-9653019499
Pay: ₹25,000.00 - ₹40,000.00 per month
Work Location: In person
