EXECUTIVE TPA

Company Overview

Sir H. N. Reliance Foundation Hospital & Research Centre is a leading multi-speciality tertiary care hospital located in Mumbai. Renowned for its state-of-the-art infrastructure and commitment to patient care, the hospital offers advanced diagnostic services and a wide range of specialities, including Cardiac Sciences, Oncology, and Women's Health. Since its inception in 1918, the institution has been synonymous with excellence and innovation in healthcare delivery, reflecting a deep respect for life and legacy of service.

Job Overview

The position of Executive TPA at Sir H. N. Reliance Foundation Hospital & Research Centre is a full-time junior-level role based in Mumbai. The ideal candidate should have between 1 to 3 years of experience and will be responsible for TPA coordination and claims processing. This role requires comprehensive knowledge of health insurance processes and effective patient communication.

Qualifications and Skills

• Experience in TPA coordination and handling insurance claims efficiently (Mandatory skill).
• Proficiency in processing claims, ensuring compliance with standard procedures (Mandatory skill).
• Skillful in patient communication, empathizing and effectively addressing patient queries.
• Thorough understanding of health insurance policies and coverage benefits.
• Knowledge of hospital management systems to facilitate seamless operations.
• Expertise in managing discharge processes, ensuring a streamlined patient experience.
• Proficiency in customer relationship management to enhance patient satisfaction.
• Strong documentation skills for effective record-keeping and communication with stakeholders.

Roles and Responsibilities

• Coordinate with third-party administrators to manage insurance claims processing effectively.
• Handle patient inquiries relating to insurance coverage and process medical claims accurately.
• Maintain a comprehensive understanding of various health insurance policies available to patients.
• Ensure all hospital management systems are updated with patient insurance details and claims status.
• Assist in the discharge process, liaising with patients and departments to facilitate timely discharges.
• Maintain strong relationships with TPAs and other stakeholders to support seamless operations.
• Prepare and manage documentation relating to claims and insurance regularly.
• Provide timely and accurate reports on claim status and patient interactions to management.