Assistant Manager - TPA

Job Description

Ensuring timely completion of all internal deliverables and maintaining MIS, reports, etc for management information purpose. Handling investigation and fraud detection in health and personal accident claims. Responsible for maintaining strong relationship with TPA and Insurance Companies. Liaison for smooth flow of pre-authorization request for all corporate and retail health policies Liaison for effective cashless and reimbursement claim process Liaison with external TPAs for timely processing of cashless and reimbursement claims Involved in TPAs claims audit and maintaining Service Level Adherence with them Monthly claims review meeting with clients & TPA’s. Handling settlement TAT’S Monitoring of retrieval claims, and quality control Monitoring TPA’s function to ensure quality & accuracy in cashless & reimbursement claim settlement Strictly maintaining Service Level Adherence and complaint management with the teams end with good and timely coordination Handling all audits internal or client requested