39 Tpa Billing Jobs

Roles and Responsibilities: Planning of the teaching programme including an orientation programme in consultation with the HOD Academics. Planning for students Practical experience, ward assignments and trainings in consultation with the HOD Academics. Planning of curriculum with the cooperation and collaboration of the HOD Academics. Competent in Handling Hospital Front desk in terms of Patient Appointments and queries. Preferred Team handling exposure of patient care coordinators. Inbuilt empathy towards the patient and patient relatives. Knowledge of Hospital Billing components for IPD and OPD. Experience of handling TPA coordination and TPA queries for cashless facility. Knowledge of Hospital Billing and tax law applicable to the hospital or healthcare industry. Competent in Professional English (written and spoken) in terms of different professional - operational scenarios. Proficient in training to provide outstanding services and ensure customer satisfaction. To educate students on how to address customer concerns and complaints promptly and professionally. To respond to customer needs and requests in a timely manner. Competent in teaching telephone etiquettes and resolve queries. To train to resolve billing concerns of customers and handle card and cash transactions. Knowledge of healthcare operations and quality parameters. Excellent communication, IT Skills and people skills. Desired Skill Sets: Excellent professional knowledge. Excellent written and verbal communication skills. Good computer skills. Broad-minded personality, which is open and curious about new teaching methods, responsible, reliable, team-minded and resilient. Attention to detail, empathy and inclusive approach. Qualification: MBA/MHA Hospital and Healthcare management with 1 to 3 years of experience or any graduate with experience in hospital billing department with 3 to 4 years of experience. Experience : Minimum 2 years of Clinical experience with one year of experience working in Hospital billing department or 2-4 years of experience in Hospital Management. Location:Mira road . 3 Years of fixed terms contract. . Request you to please share your updated CV at shruti.m@techmahindrafoundation.org TMF is committed to provide equal employment opportunities for all and foster a diverse and inclusive workplace.

Liaison between patients, the hospital, and insurance companies or TPAs, managing insurance claims, processing pre-authorizations, and ensuring efficient communication for cashless and other insurance-related processes.

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Simran Sandhu 7696661783

Walkin : Mon to Sat between 11am to 3pm - Siruseri Unit Job Title: Insurance Co-ordinator Role & responsibilities: List out the total Number Of credit patients (All Insurance). To send the Pre- Authorization form to the concern insurance company. Explain the Admission & Discharge procedure to the patient & attenders also. All data's and activities should be computerized. Watch the approval status and query reply to be update shortly. To Proper communication about the patient Admission, Approval, Enhancement procedure, Discharge, Payment, and cancellation process. The most common job duties for a health unit coordinator are clerical tasks like answering phones and processing paperwork, including discharge, transfer, and admittance forms. Health unit coordinators also often act as a liaison between patients, nurses, doctors, and different departments within the hospital or care facility. Other tasks can include scheduling procedures like tests and x-rays, transcribing doctors' orders, and ordering medical and office supplies. Health unit coordinators are a part of a broader medical team, and are expected to keep pace with the potentially hurried and stressful environments in which they work. Heath care coordinators work closely with patients on a one-on-one basis. They provide guidance, support, and advice to patients dealing with complex medical issues. These professionals can help their clients navigate through a medical care scenario that may involve a variety of different doctors and treatment methods. Duties can include scheduling appointments, assisting with major decisions, helping patients understand complex medical information, evaluating care quality, and working with other health care professionals to ensure that the correct path is being taken. To Properly Intimate the consultants about credit limits. To make sure the Surgery details, Summary follow ups with consultants. To maintain the good rapport with consultants. Follow ups for consultant Payments. Reporting to Head of the department. Job Title: Executive - Credit Recovery Role & responsibilities: Marking Despatch details & updating claim details in KMH Internals Combinedly doing OS reconciliations as required with TPA/Corporates Sending out monthly OS statements / letters to TPA. / Corporates as may be agreed from timeline Marking Despatch details & updating claim details in KMH Internals Delivering Doctor's cheque with in time line Receiving acknowledgements for cheques submission from doctor & closing the entry in KMH DERN Collecting our Hospital other unit bills & submitting at agreed corporates. Follow up with TPA/Corporates for refund of collectible disallowance Regular follow up for renewing for MOU with TPA/Corporates Submitting Hospital Revised Tariff list to TPA / Insurance Reporting to Senior Officer - Credit Recovery Preferred candidate profile: Any Degree Holder (UG/PG Arts & Science) A minimum of 2 to 10 years of experience in Insurance. Working knowledge of Insurance standards Proficient in Microsoft Office. Strong attention to details. Perks and benefits: ESI, EPF Gratuity Contact person: Naveenkumar - HR - omrhr@drkmh.com

Key Responsibilities Inpatient Billing Operations Prepare and finalize inpatient bills with 100% accuracy. Monitor and update provisional bills daily for admitted patients. Post all charges (consultation, procedures, pharmacy, diagnostics, room rent, consumables, etc.) correctly. Ensure billing adherence to hospital tariffs, package policies, and inclusions/exclusions. TPA/Insurance Coordination Handle admission intimation and obtain pre-authorization from TPAs/insurance companies. Submit necessary documents (admission notes, investigations, treatment plans) to insurance/TPAs on time. Track and follow up on approvals, enhancements, and extensions for continued stay. Align final billing strictly as per TPA/insurance approval limits and policy guidelines. Resolve TPA-related billing discrepancies with proper documentation. Coordinate with consultants for timely discharge summary, medical records, and required justification for claim approvals. Ensure discharge is processed only after receipt of TPA final approval/guarantee of payment. Patient Interaction & Support Counsel patients/attendants on billing and insurance queries. Share cost estimates and provisional updates transparently during hospitalization. Provide clarity on insurance coverage, co-payments, and exclusions. Audit, Compliance & Reporting Reconcile daily billing and insurance transactions. Maintain accurate billing and insurance records for audits. Ensure compliance with NABH/JCI and hospital billing guidelines. Prepare periodic MIS reports on IP billing, TPA receivables, and claim status. Team & Process Management Support and guide junior billing/TPA staff. Identify gaps in billing/TPA processes and suggest improvements. Escalate unresolved cases to Billing Manager for timely closure. Key Skills & Competencies Strong knowledge of hospital IP billing & TPA/insurance processes. Proficiency in Hospital Information Systems (HIS) and billing software. Good communication, negotiation, and counseling skills. Detail-oriented with strong numerical and analytical ability. Ability to handle billing disputes diplomatically under pressure. Qualification & Experience Graduate in Commerce / Finance / Hospital Administration (MBA preferred). 47 years of experience in hospital IP billing and TPA operations. Hands-on experience in insurance/TPA pre-authorization, approvals, and claims mandatory.

MBA (Finance) or Inter CA with strong experience in hospital billing systems and audit processes.

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Astha Saklani 7087994355 Sr. Talent Acquisition

Role: Senior Executive - Account Management Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Non voice coordinator Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Interested candidate can share their resume to varsha.kumari@mediassist.in

Role & responsibilities review and verify TPA deductions made from hospital bills. Cross-check claims, pre-authorizations, and payment details from TPAs to identify discrepancies. Reconcile payment and deduction reports with hospital billing and accounting records. Coordinate with insurance companies, TPAs, and internal departments to resolve deduction-related issues. Follow up on pending claims and deductions to expedite payments. Prepare regular reports on TPA deductions and highlight areas of concern or delay. Assist in audits and compliance checks related to TPA billing and deductions. Maintain accurate documentation and records of all deduction transactions. Provide support to the billing and finance teams regarding TPA-related queries. Stay updated on insurance policies, TPA guidelines, and regulatory requirements. Preferred candidate profile experience in hospital billing, insurance claims, or TPA deduction management preferred. Understanding of healthcare insurance processes and TPA operations. Strong analytical and reconciliation skills. Good communication and coordination abilities. Proficiency in MS Office (Excel, Word) and hospital billing software. Attention to detail and accuracy.

Role: Senior Executive - Account Management Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Non voice coordinator Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. NOTE: Must have TPA or Insurance work experience for min 1-2 yrs

Role: Senior Executive - Account Management Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Non voice coordinator Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. NOTE: Must have TPA or Insurance work experience for min 1-2 yrs

The ideal candidate should have experience in TPA billing and counseling. This includes submitting insurance claims accurately and on time, verifying the completeness of claim documents, and maintaining relationships with TPAs and insurance companies. As part of the role, you will be required to negotiate service agreements, monitor performance, and address any issues related to claim settlements or delays. It will also be important to confirm patient insurance coverage, obtain pre-authorizations for treatments and procedures, and coordinate with medical staff and insurers for approval. A key aspect of the position will involve tracking reimbursement trends, optimizing revenue, reducing claim denials, and improving approval rates. Collaborating with the accounts team for appeals and adjustments, generating reports on claims status and TPA performance, and ensuring compliance with healthcare insurance regulations will be essential responsibilities. Additionally, updating internal policies to reflect regulatory changes, handling patient inquiries about insurance and billing, and providing support for denied claims and billing disputes will be part of the daily tasks. This is a full-time position with benefits including Provident Fund. The work location is in person.,

Responsibilities: * Manage backend operations with focus on health insurance claims processing, TPA billing, MIS reporting, data entry, and basic hospital administration. Provident fund Annual bonus

Role & responsibilities • To be responsible for maintaining TPA Processing of cashless and all post discharge health insurance claims. • To be responsible to maintain overall TAT entry to exit. • TPA query reply and preauthorisation follow up with insurance company / tpa. • Medical scrutiny and medical opinion for health insurance claims. • Efficient in claim adjudication and claim processing. • Maintaining and ensuring Standard Operating Procedures and protocols. • To be responsible for keeping record for all correspondence done for TPA. • Post discharge reconciliation for utilization of claims. • Timely reply to internal TPA complaint portal. • TPA discharge follow up and closure. • Mmaintenance of departmental records as per the NABH requirement. • Effective utilization of hospital information system, MIS generation of TPA patients. • To display proactive cooperation and contribute to cordial inter and intra team relations, solution orientation and team solidarity. Should be cost effective. • To participate in training programs to maintain and update your professional knowledge. • To achieve high levels of customer satisfaction at each interaction. • Any task assigned to you by your HOD from time to time. Preferred candidate profile Accuracy in invoicing / billing • Demonstrated ability to maintain confidentiality • Service Excellence • Active participation in all departmental training and development activities. • Active participation in Inventory Management. Min 2 Years of relevant experience in TPA Must be Graduate

Cashless Executive, TPA Executive, Insurance Executive Responsibilities: Patient Eligibility Verification: Claim Processing: Pre-authorization and Approvals: Coordination: Status Tracking and Follow-up: Cashless Admission Facilitation:

Role & responsibilities Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills. Good communication skills in Hindi/English and regional language of the state/region. Ready to relocate himself/herself at location within India as may be required according to the job requirement Candidate must own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally 20-25 Hospitals for Case Audit and Management Proficient in handling complex situations and customers. Candidate must possess clinical knowledge for evaluation of medical files Sound knowledge of surgical procedures and disease cure management Preferred candidate profile

Role & responsibilities 1) 1-3 years working experience in health insurance/health insurance TPA at Hospital handling/audit 2) Candidate must have excellent knowledge of health insurance / Health TPA domain. 3) Candidate must have excellent bill/medical negotiation skills & customer handling skills. 4) Good communication skills in Hindi/English and regional language of the state/region. 5) Ready to relocate himself/herself at location within India as may be required according to the job requirement . 6)Candidate must own vehicle to travel in various hospital assigned to him 7) MS Office and excel Preferred candidate profile Proficient in handling complex situations and customers. Candidate must possess clinical knowledge for evaluation of medical files Sound knowledge of surgical procedures and disease cure management Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally 20-25 Hospitals for Case Audit and Management.

Job Description 1 Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit 3 Candidate must have excellent knowledge of health insurance / Health TPA domain. 4 Candidate must have excellent bill/medical negotiation skills & customer handling skills. 5 Good communication skills in Hindi/English and regional language of the state/region. 6 Ready to relocate himself/herself at location within India as may be required according to the job requirement 7 Candidate must own vehicle to travel in various hospital assigned to him 8 Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals 9 Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally 20-25 Hospitals for Case Audit and Management 10 Proficient in handling complex situations and customers. 11 Candidate must possess clinical knowledge for evaluation of medical files 12 Sound knowledge of surgical procedures and disease cure management

Job Description 1 Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit 3 Candidate must have excellent knowledge of health insurance / Health TPA domain. 4 Candidate must have excellent bill/medical negotiation skills & customer handling skills. 5 Good communication skills in Hindi/English and regional language of the state/region. 6 Ready to relocate himself/herself at location within India as may be required according to the job requirement 7 Candidate must own vehicle to travel in various hospital assigned to him 8 Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals 9 Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally 20-25 Hospitals for Case Audit and Management 10 Proficient in handling complex situations and customers. 11 Candidate must possess clinical knowledge for evaluation of medical files 12 Sound knowledge of surgical procedures and disease cure management

TPA - Claim Processing

MBA (Finance) or Inter CA with strong experience in hospital billing systems and audit processes.

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Isha Thakur 9056448144 HRD

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Isha Thakur 9056448144 HRD