TPA Claim Executive- Rungta Hospital

Rungta Hospital

2 - 5 years

2 - 3 Lacs

jaipur

Posted:3 weeks ago| Platform:

Apply

Skills Required

tpa claim health claims mediclaim claims management tpa claim settlement claims handling claims adjudication claims processing health insurance

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Coordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements.
Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format.
Follow up regularly with TPAs for claim status, pending queries, and settlement updates.
Verify patient insurance details, coverage, and eligibility before admission and discharge.
Maintain accurate and up-to-date records of all claims submitted and settled.
Handle rejections, discrepancies, and short settlements by coordinating with relevant departments and TPAs.
Ensure compliance with hospital policies and TPA/insurance requirements.
Generate periodic reports on claims pending, approved, rejected, and under process.
Coordinate with the billing department to ensure correct patient billing as per TPA tariff and agreement.
Support audits and maintain proper documentation for all claim-related activities.

Preferred candidate profile

Good knowledge of TPA, insurance processes, and hospital billing systems.
Strong communication and coordination skills.
Attention to detail and accuracy in documentation.
Proficiency in MS Excel and hospital billing software (HIS).
Ability to manage multiple claims and meet deadlines.

More Jobs at Rungta Hospital

Head Operations

Jaipur

5.0 - 10.0 yrs

INR 7 - 10 Lacs

Pharmacist

Jaipur, Rajasthan

Experience: Not specified

INR 0 - 0 Lacs

Pharmacist

Jaipur

Experience: Not specified

INR 0 - 0 Lacs

Staff Nurse

Malviya Nagar, Jaipur

Experience: Not specified

INR 0 - 0 Lacs

Pharmacy Head

Jaipur

Experience: Not specified

INR 0 - 0 Lacs

Mock Interview

Practice Video Interview with JobPe AI

Start Job-Specific Interview

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.