20 Tpa Coordination Jobs

As an Executive - Insurance at Hexa Health in Gurugram, you will be responsible for handling cashless and reimbursement claims, coordinating with TPAs, obtaining pre-authorization approvals, and addressing insurance queries. Your role will include verifying billing, liaising with doctors, and ensuring compliance with standard operating procedures. Your success in this position will require strong relationship management skills and a deep understanding of health insurance policies. Your key responsibilities will include: - Managing cashless and reimbursement claims from initiation to settlement. - Ensuring accuracy in discharge summaries and TPA billing for billing and discharge verification....

Role & responsibilities Short Paid Claim Contesting Executive-Drive timely and accurate contesting of short-paid claims across hospital-insurer interfaces, ensuring recovery yield and SOP compliance. Analyze short-paid claims and categorize by deduction type, insurer, and RCA triggers. Draft and submit contest letters with supporting documentation via IHX and insurer portals. Track contesting outcomes and escalate unresolved cases per SLA timelines. Collaborate with unit credit cells and central recovery team for RCA discipline and documentation hygiene. Maintain dashboards for contesting status, win-loss ratios, and financial impact. Ensure adherence to SOPs and flag deviation trends for go...

Role & responsibilities Maximize recovery of outstanding claims from TPAs and insurers through disciplined follow-up, documentation, and stakeholder coordination. Monitor aging reports and follow up on pending claims across TPAs and insurers. Coordinate with internal billing, credit cell, and finance teams for claim documentation and query resolution. Engage with insurer/TPA representatives to expedite settlements and resolve disputes. Maintain tracker for recovery status, escalations, and financial realization. Support RCA documentation and contesting for short-paid or denied claims. Prepare weekly MIS and recovery dashboards for leadership review. Preferred candidate profile Familiarity wi...

Verify patients insurance coverage and benefits Handle and submit insurance claims Communicate with insurance companies Resolve claim denials and issues Ensure accurate billing and coding Maintain up-to-date patient insurance records Assist patients with insurance-related questions

Job Title: Helpdesk Consultant (Account Management) Location: Main Primary: Client Site Electronic City Phase 2, Bangalore (1 Vacancy) Employment Type: Full-time (Consultant Role) Note: Based on performance, the role may be extended or converted to a permanent position after 12 months Work Timings: Monday to Friday: 11:00 AM to 7:30 PM 2nd and 4th Saturdays and all Sundays: Weekly off 1st, 3rd, and 5th Saturdays: As per office roster CTC: 3 LPA to 3.5 LPA (Based on current ctc) Experience Required: 1 to 5 years About the Role We are hiring a Consultant Account Management (Helpdesk) to manage insurance-related support and enrollment activities at our client location. The selected candidate wi...

You are a detail-oriented and efficient TPA & Mediclaim Executive responsible for managing insurance claim processing and coordination with Third Party Administrators (TPAs). Your primary role involves overseeing the entire lifecycle of patient insurance claims, from admission to final settlement, ensuring accurate and timely processing. Your key responsibilities include coordinating with TPAs and insurance companies for cashless approvals and claim settlements, handling patient admission and discharge processes related to insurance, collecting, verifying, and submitting necessary documentation for claims processing, following up on pending claims, maintaining accurate records of all TPA tra...

Urgent Requirement of Executive TPA Qualification-Graduation Location- Greater Noida Kailash Hospital Requirements: Minimum 1 year of experience in TPA / Insurance desk in a hospital setup

Ensure the invoice is done without any delay Also, need to ensure that the Invoice is submitted to the respective payers on time Payment follow-up religiously and ensure that the DSO is maintained as per the credit terms signed during empanelment Handling queries Working closely with the branch TPA coordinator to track the claim submission. Also should be strong in data analysis only then he can have control of the aging of the payers Ensure timely reports to the Corporate office Need to work on Target and achieve the same month on month. Reporting loss of revenue leakage Interested Candidate can send their CVs on 9712687709 or email on mariya.a@dragarwal.com

As a Hospital Administrator at Shatayu Hospital in Jejuri, Pune, you will be responsible for overseeing administrative operations, including billing, TPA coordination, and general hospital administration. Your role will involve managing day-to-day activities, patient billing, insurance coordination, and ensuring compliance with healthcare regulations and internal policies. You will work closely with consultants, nursing staff, and patients to ensure smooth operations and handle patient queries, grievances, and feedback. To succeed in this role, you will need to have a graduate or postgraduate degree in Hospital Administration or Healthcare Management, along with a minimum of 2-5 years of exp...

As a TPA (Third Party Administrator) Manager, you will be responsible for overseeing and managing the relationship between the insurance company, healthcare providers, and policyholders. Your primary role will involve ensuring the smooth processing of health insurance claims, handling grievances, and maintaining compliance with regulatory requirements. Your key responsibilities will include managing the entire health insurance claim process, from initiation to settlement. You will need to coordinate with insurance companies, hospitals, and policyholders to ensure timely processing while maintaining accuracy in documentation and compliance with regulations. Additionally, you will be required ...

JOB DESCRIPTION Role / Designation: IP Billing Manager Reporting to: Unit Admin Head SBU / Division / Department: IP Billing Location / Branch : Gachibowli JOB OVERVIEW Financial counselling, bill preparation, insurance approvals. Admission, Discharges, preparing MIS reports, handle queries related to claims and reimbursements. Tracking payments made by insurance agencies and patients and training new employees in the billing department. JOB DESCRIPTION: Overall supervision, control on functioning of the Department. To attend to patient clarifications with regard to billing. To deal with billing clarifications/ information in respect to various Corporates/ Institutions having tie up with hos...

Role & responsibilities Candidate with good academic and proficiency in MS Office and good communication skills required. Preferred candidate profile

The ideal candidate for this role will have experience in managing TPA processes and insurance claims. Your strong communication and interpersonal skills will be essential in effectively coordinating with third-party administrators. Additionally, your ability to maintain accurate patient records and documentation will contribute to the smooth processing of claims. You should be detail-oriented with strong organizational skills to ensure all TPA processes are handled efficiently. Proficiency in using relevant software and systems related to TPA coordination is necessary for this position. Prior experience in the healthcare industry would be advantageous. A bachelor's degree in Healthcare Admi...

A TPA (Third Party Administrator) Manager is responsible for overseeing and managing the relationship between the insurance company, healthcare providers, and policyholders. You will ensure the smooth processing of health insurance claims, handle grievances, and maintain compliance with regulatory requirements. Your key responsibilities will include overseeing the entire health insurance claim process from initiation to settlement. You will coordinate with insurance companies, hospitals, and policyholders for timely processing while ensuring accuracy in documentation and compliance with regulations. Reviewing high-value or complicated claims and approving based on policy guidelines will also...

Role & responsibilities JOB DESCRIPTION Role / Designation: IP Billing Manager Reporting to: Unit Admin Head SBU / Division / Department: IP Billing Location / Branch : Attapur JOB OVERVIEW Financial counselling, bill preparation, insurance approvals. Admission, Discharges, preparing MIS reports, handle queries related to claims and reimbursements. Tracking payments made by insurance agencies and patients and training new employees in the billing department. JOB DESCRIPTION: Overall supervision, control on functioning of the Department. To attend to patient clarifications with regard to billing. To deal with billing clarifications/ information in respect to various Corporates/ Institutions h...

Key Deliverables: Achieve business targets from TPA and corporate clients Maintain and renew empanelment with TPAs and corporates Organize and execute health camps and corporate outreach programs Ensure timely insurance query resolution and payment follow-ups Role Responsibilities: Develop new corporate and insurance partnerships Strengthen rapport with existing TPA and insurer networks Track and fulfill service quality commitments Handle all communications related to insurance approvals and guarantees

Key Deliverables: Ensure accurate inpatient billing aligned with insurance and TPA protocols Oversee daily IPD operations and coordinate with clinical and admin teams Manage billing discrepancies, approvals, and pre/post discharge processing Lead and train staff for service quality and compliance with SOPs and ISO standards Role Responsibilities: Monitor billing accuracy, package mapping, and CGHS/PSU documentation Handle queries, feedback, and patient financial counselling Coordinate interdepartmental workflows for timely discharge processes Track and improve IPD service delivery using HIS and MIS systems

Crucial role in managing the entire claims process — right from documentation and coordination to ensuring smooth and timely settlements.

Experienced and licensed medical professional (MBBS/MD) with a strong background in medical claims assessment and clinical evaluation within the health insurance or TPA industry. Skilled in reviewing pre-authorization requests, hospitalization claims, and medical documentation to ensure medical necessity, policy compliance, and regulatory standards (IRDAI). Proficient in ICD-10 coding, claims adjudication, and fraud detection, with a focus on accuracy, ethical judgment, and collaborative decision-making. Adept at coordinating with hospitals, TPAs, and internal teams to streamline claim processing and maintain service quality.

Job Title: Helpdesk Consultant (Account Management) Location: Primary: Client Site Electronic City, Bangalore (1 Vacancy) Primary: Client Site Hosur TATA Electronics (1 Vacancy) Secondary: Medi Assist Office IBC Knowledge Park, SG Palya, Bangalore Employment Type: Full-time (Consultant Role) Note: Based on performance, the role may be extended or converted to a permanent position after 12 months Work Timings: Monday to Friday: 11:00 AM to 7:30 PM 2nd and 4th Saturdays and all Sundays: Weekly off 1st, 3rd, and 5th Saturdays: As per office roster CTC: 3 LPA for Bangalore location, negotiable based on current CTC for Hosur location. Experience Required: 1 to 5 years About the Role We are hiring...