IPD -OPD Billing ( TPA)

Please Note : Only Hospital Experience Candidate can apply.

Key Responsibilities

• Coordinate patient discharge with doctors, nursing staff, and billing department
• Prepare final bills at the time of discharge for cash and insurance patients
• Ensure completion of all discharge documentation

TPA & Insurance Handling

• Handle end-to-end TPA/insurance cases from admission to discharge
• Verify insurance eligibility, policy coverage, and exclusions
• Submit pre-authorization and enhancement requests to TPAs/insurers
• Follow up with TPAs/insurance companies for approvals and queries

Billing & Claims

• Prepare accurate bills as per TPA/insurance agreements and hospital tariffs
• Ensure correct coding and documentation as per insurer requirements
• Submit final claims within stipulated timelines
• Coordinate for claim settlements and resolve rejections or discrepancies

Documentation & Compliance

• Maintain complete and accurate patient billing records
• Ensure compliance with hospital policies, NABH standards, and insurance norms
• Keep track of pending claims, approvals, and settlements

Coordination & Communication

• Act as a liaison between patients, TPAs, insurance companies, doctors, and hospital staff
• Explain billing and insurance-related queries to patients and attendants
• Escalate issues related to delayed approvals or settlements

Required Qualifications

• Graduate in any discipline (preferred: Healthcare Management / Commerce)
• Certification or training in Medical Billing / TPA operations is an advantage

Experience

• 3–5 years of experience in hospital billing and TPA operations
• Experience in multi-specialty hospital preferred

Skills & Competencies

• Strong knowledge of TPA and insurance processes
• Good understanding of hospital billing systems and tariffs
• Excellent communication and coordination skills
• Attention to detail and accuracy
• Proficiency in hospital information systems (HIS) and MS Office

Key Performance Indicators (KPIs)

• Timely discharge processing
• Accuracy of billing and documentation
• Reduction in claim rejections
• Turnaround time for TPA approvals and settlements

Job Types: Full-time, Permanent

Pay: ₹200,633.21 - ₹300,000.00 per year

Benefits:

• Cell phone reimbursement
• Health insurance
• Provident Fund

Work Location: In person