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TPA and Insurance Tie-Up Co-ordinator

RxDx Clinics (Multi-speciality)
Whitefield, Bengaluru, Karnataka

Quick apply

Job details

Permanent | Full-time
From ₹35,000 a month
8 hours ago

Benefits

Provident Fund
Leave encashment
Paid time off
Life insurance
Food provided

Qualifications

B.Sc
B.Com
English
Local language
Science
Bachelor's degree
BBA
Business Administration
Diploma
Medical terminology
Billing
Communication skills

Full job description

Job Title: TPA & Insurance Tie-ups Coordinator

Department: Business Development

No. of Positions: 1

Position Type: Full-Time (Work from Office)

Location: Whitefield, Bengaluru

About RxDx

RxDx Clinics is a Bengaluru-based NABH-NABL accredited multispeciality healthcare chain. Founded in 2007, RxDx is guided by the core principles of

delivering the best health outcomes, at optimal cost, with utmost patient satisfaction.

Two main hubs of RxDx are located at Whitefield and Malleswaram, with peripheral branches in Kadugodi and Siddapura. In 2023, RxDx expanded with new centres at Dommasandra Circle and Diamond District, Domlur. In 2024, the organisation strengthened its presence in North Bengaluru with its flagship clinic in Jakkur and its first apartment clinic at RxDx Alpine Eco.

In 2025, four new centres were inaugurated at RR Nagar, Adarsh Palm Retreat (Bellandur), Electronic City, and Budigere Cross. Including its corporate health partnerships, RxDx now operates approximately 30 medical centres across Bengaluru.

Job Summary

RxDx is looking for a TPA & Insurance Tie-ups Coordinator to manage the end-to-end cashless insurance process, including empanelment with insurance companies and TPAs, pre-authorizations, claim management, and final settlements.

The role requires strong knowledge of health insurance workflows, IRDAI guidelines, and coordination with TPAs, insurance auditors, doctors, and internal billing teams to ensure smooth approvals and minimal claim deductions. The candidate will also support patients and families during admissions and discharges, ensuring transparency and timely processing of insurance claims.

Key Responsibilities

Strategic Insurance Tie-ups & Relationship Management

Initiate and manage empanelment (tie-ups) with new Insurance Companies and Third-Party Administrators (TPAs).
Coordinate with management during negotiation of package rates and MOU terms for procedures and surgeries.
Maintain strong working relationships with TPA managers to expedite approvals and resolve disputed claims.
Ensure timely renewal of existing insurance and TPA agreements and MOUs.

Cashless Desk & Pre-Authorization Management

Counsel patients and attendants regarding insurance coverage, exclusions, eligibility, and the cashless process at the time of admission.
Collect required clinical and administrative documents and initiate pre-authorization requests through TPA portals or email within stipulated timelines (typically 2–6 hours of admission).
Coordinate with treating consultants to promptly respond to medical queries raised by TPA doctors.
Raise enhancement requests with appropriate clinical justification if treatment costs exceed initial approvals.

Claims Processing & Discharge Coordination

Compile final bills, discharge summaries, and investigation reports to obtain final authorization from TPAs at the time of discharge.
Identify and resolve discrepancies between hospital bills and approved amounts to minimize deductions.
Support reimbursement cases by preparing and providing complete, signed, and stamped documentation to patients.

Compliance, Documentation & Reporting

Ensure adherence to IRDAI guidelines, GIPSA norms, and insurer-specific workflows.
Maintain accurate records of approvals, claims, denials, and settlements.
Track and monitor key KPIs such as pre-authorization turnaround time, claim settlement ratio, and denial rates.

Qualifications & Experience

Education: Graduate in any stream (B.Com / BBA / B.Sc preferred). Diploma in Health Insurance or Hospital Administration is an added advantage
Experience: 2–5 years of hands-on experience at a Hospital Insurance / TPA Desk.
Proven track record of maintaining a low claim rejection or denial ratio.

Key Competencies & Skills Insurance & Domain Knowledge

Strong understanding of IRDAI regulations, GIPSA portals, and insurance workflows.
Familiarity with major TPAs and insurers (Medi Assist, Raksha, Star Health, etc.).
Ability to understand medical terminology, ICD-10 diagnoses, and procedure codes for claim justification.

Technical & Operational Skills

Proficiency in Hospital Information Systems (HIS) and insurance/TPA portals.
Strong documentation, tracking, and follow-up capabilities.

Communication & Stakeholder Management

Excellent verbal and written communication skills in English and local language.
Ability to handle stressed patients, attendants, and insurance auditors with empathy and patience.
Strong coordination skills with doctors, billing teams, and insurance representatives.

Professional Integrity & Work Ethic

High attention to detail and confidentiality.
Ability to work under pressure and meet strict timelines
Self-driven, organized, and process-oriented.

Why Join RxDx?

Be part of a reputed NABH-NABL accredited multispecialty healthcare organization.
Opportunity to work closely with leading insurance companies and TPAs.
Structured processes, learning exposure, and career growth in healthcare insurance operations.

Application Process

Interested candidates are requested to apply on our website using the link: https://rxdx.in/careers-at-rxdx/, or reach out to:

Contact Person: Ms Metilda Joy

HR Team, RxDx Clinics

Plot No. 7G, Ground Floor, Council Khata 180/63 Vishveshwarya Industrial Area, Whitefield, Bengaluru – 560048

Phone: 6360 152070

Email: [email protected]

Instructions for Email Application:

Email subject: “TPA & Insurance Tie-ups Coordinator – RxDx Clinics, Bengaluru”
Attach your CV with the filename: “Your Name – CV”

Pay: From ₹35,000.00 per month

Benefits:

Food provided
Leave encashment
Life insurance
Paid time off
Provident Fund

Work Location: In person

Quick apply

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