Requirement for Hospital TPA

A TPA (Third Party Administrator) job in a hospital involves acting as a liaison between patients, hospitals, and insurance companies to process claims, manage health insurance policies, and resolve billing issues.

Key Responsibilities

• Claim Management: Coordinate the end-to-end TPA process for insurance claims, from patient admission to discharge, ensuring accurate documentation and billing.
• Insurance Verification: Review and verify patient health insurance coverage, eligibility, and policy benefits to ensure claims are processed within scope.
• Liaison with Insurers: Act as the hospital's representative to interact with insurance companies and their TPAs, following up to clear claims and authorize treatments.
• Patient Support: Guide patients on insurance processes, explain policy inclusions/exclusions, and provide information on claim status and reimbursement procedures.
• Documentation & Records: Maintain accurate records of all patient and stakeholder interactions and process patient claims, ensuring the correct submission of information and documentation.
• Portal Management: Handle and manage TPA online portals, which are used for submitting and tracking claims and other related transactions.
• Reconciliation: Update and reconcile implant bills to ensure accurate financial records.
• Reporting: Prepare and share regular reports, including MIS (Management Information System) reports, to inform management about TPA operations.

Job Types: Full-time, Fresher

Pay: ₹18,000.00 - ₹25,000.00 per month

Benefits:

• Health insurance
• Provident Fund

Education:

• Bachelor's (Preferred)

Experience:

• TPA: 1 year (Preferred)

Language:

• English (Preferred)

Work Location: In person