Head of TPA Health Claims Operations – Insurance / TPA Domain

Key Responsibilities:

• Lead the operations team handling pre-authorization, claims adjudication, hospital coordination, and audits
• Liaise with insurance companies, brokers, and provider networks
• Ensure compliance with all regulatory (IRDAI) guidelines and reporting standards
• Drive SLA adherence, customer satisfaction, and process improvements
• Oversee claim software workflows and backend processing efficiency
• Manage team performance, training, and coordination across departments

Desired Candidate Profile:

• 7+ years of experience in health insurance claims or TPA operations
• In-depth knowledge of cashless and reimbursement workflows
• Strong understanding of hospital empanelment and insurer relationships
• Hands-on experience in regulatory compliance, billing, and reporting
• Excellent leadership, communication, and team management skills

*Job Opportunity: Experienced Candidate in TPA Healthcare*

We are looking to hire a candidate with experience in a TPA (Third-Party Administrator) healthcare provider company as Operation Head. Specifically, we are seeking individuals who have worked with renowned TPAs such as:

1. Medi Assist Insurance TPA Private Limited.

2. MDIndia Health Insurance TPA Private Limited,

3. Paramount Health Services & Insurance TPA Private Limited

Heritage Health Insurance TPA Private Limited

Job Type: Full-time

Pay: ₹40,000.00 - ₹70,000.00 per month

Schedule:

• Day shift

Ability to commute/relocate:

• North Twenty Four Parganas, West Bengal: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

• Are you an experienced leader in health insurance or TPA operations?

Education:

• Bachelor's (Preferred)

Work Location: In person