As a TPA Executive, you will be responsible for managing and overseeing various aspects of third-party administration services for clients
Your primary goal will be to ensure the smooth and efficient processing of claims and other administrative functions while maintaining high levels of customer satisfaction
You will collaborate with internal teams and external stakeholders to deliver exceptional service and meet client expectations

Responsibilities:

Claims Management: Handle and process insurance claims efficiently and accurately, adhering to the company's guidelines and relevant regulations
Client Communication: Serve as the main point of contact for clients, addressing inquiries, resolving issues, and providing updates on claim statuses
Policy Administration: Review and validate insurance policy details to ensure correct coverage and policy benefits for claim processing
Documentation and Record Keeping: Maintain accurate records of all claim-related documents, transactions, and communications
Coordination with Healthcare Providers: Liaise with hospitals, doctors, and other healthcare providers to facilitate the smooth processing of medical claims
Network Management: Collaborate with the network management team to maintain a strong network of healthcare providers and negotiate contracts with them
Quality Assurance: Implement and maintain quality assurance processes to ensure accurate and timely claim processing
Reporting: Prepare and present reports on claim processing metrics, performance, and client satisfaction

Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.

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Sr Exceutive TPA