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Medical offier
MEDI ASSIST INSURANCE TPA PRIVATE LIMITED —Andheri, Mumbai, Maharashtra
Coordinate with the LCM team in case of higher. Claims and raise an IR in case of an insufficiency. And an RI claim and verify the necessary details.
₹22,000 - ₹30,000 a month
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Claim Processing Executive (Health Insurance)
Watch Your Health.com India Pvt Ltd —Mumbai, Maharashtra
0–3 years of experience in health insurance claims processing. Prior experience in health insurance claims processing/TPA/hospital insurance desk preferred.
₹18,000 - ₹25,000 a month
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13d

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Key Responsibilities of a TPA Coordinator

Core Responsibilities1. Insurance & TPA Coordination

Coordinate with insurance companies and TPAs for cashless hospitalization approvals.
Handle pre-authorization and claim documentation processes.
Follow up on pending approvals, claim settlements, and reimbursement status.
Maintain strong communication with TPAs, insurance representatives, and hospital departments.

2. Patient Assistance

Guide patients and attendants regarding insurance procedures and required documents.
Explain cashless policies, coverage details, exclusions, and claim processes.
Assist patients during admission and discharge formalities related to insurance.

3. Documentation Management

Verify patient insurance documents and policy details.
Ensure accurate preparation and submission of claim forms, bills, discharge summaries, investigation reports, and supporting documents.
Maintain records of approvals, denials, claims, and settlements.

4. Billing & Claim Processing

5. Claim Follow-Up & Settlement

6. Compliance & Policy Adherence

Ensure compliance with hospital policies, insurance regulations, and TPA guidelines.
Keep updated with changes in insurance policies and healthcare regulations.

7. Coordination with Internal Departments

Work closely with doctors, nursing staff, front office, medical records, and accounts departments.
Ensure smooth patient discharge process after final approval.

Pay: ₹11,000.00 - ₹20,000.00 per month

Work Location: In person