Need a TPA person for Multi-speciality hospital

Contact Mr Nishant Chaudhary WhatsApp 91050 24073

Industry & Sector:

Primary job title:

About The Opportunity

• Act as the primary liaison with TPAs and insurance providers for cashless admissions, pre-authorisations and claim settlements.
• Verify patient insurance coverage, validate documentation and complete pre-authorization workflows within TPA portals.
• Coordinate with clinical teams and billing department to compile claim dossiers, submit final bills and follow up for settlement.
• Manage claim follow-ups, chase outstanding payments, and resolve discrepancies or denials with evidence-based appeals.
• Maintain accurate records of authorisations, claim statuses and communications; escalate unresolved cases to management.
• Support process improvements for faster claim turnaround and collaborate on audit readiness and compliance checks.
  

Skills & Qualifications

Must-Have

• Graduate or diploma holder with proven experience in hospital TPA operations
• Hands-on experience with cashless authorisation and pre-authorization processes
• Demonstrable knowledge of medical billing and claim settlement workflows
• Experience using TPA portals and managing end-to-end claim submissions
• Strong tracking and documentation skills; ability to manage multiple active claims
• Willingness to work on-site at Talegaon, Pune
  

Preferred

• Prior experience in a multi-speciality hospital setting
• Familiarity with Hospital Information Systems (HIS) or EHR platforms
• Proficiency in Marathi/Hindi and English for local TPA and patient interactions
  

• Stable on-site role within a multi-speciality hospital with direct impact on patient experience and revenue cycle.
• Opportunity to work cross-functionally with clinical, billing and admin teams and grow into senior RCM/TPA roles.
• Competitive compensation aligned with experience and local market standards (Talegaon, Pune).