11 Tpa Coordination Jobs

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 experience in hospital administration, billing, and TPA coordination. Knowledge of hospital billing software and medical coding is preferred. Strong communication, interpersonal, and problem-solving skills are essential, along with the ability to multitask and manage a team effectively. This is a permanent position with benefits such as paid time off. The job location is in Jejuri, Maharashtra, so reliable commuting or plans for relocation to the area are required. If you have a background in HR with at least 5 years of experience and a Professional in Human Resources certification, it would be preferred for this role.,

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 to review high-value or complicated claims and approve them based on policy guidelines. As the TPA Manager, you will serve as the primary point of contact between healthcare providers and the insurance company. It will be your responsibility to monitor the performance of the TPA team, ensuring efficient claim handling. You will also manage relationships with multiple hospitals, negotiating terms when necessary. Ensuring compliance with all insurance regulations, industry standards, and internal policies will be a crucial part of your role. You will need to stay up-to-date with changes in insurance policies and healthcare regulations, handling escalated cases and resolving disputes related to claims or policyholder grievances. In terms of team leadership, you will be expected to lead, mentor, and manage a team of claim processors and support staff. Conducting regular training sessions on claim processes, industry trends, and regulatory updates will also fall under your purview. Monitoring team performance, setting KPIs, and ensuring objectives are met will be essential for success in this role. This is a full-time position requiring a total of 10 years of work experience. The work location is in person, and the application deadline is 15/10/2024.,

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 hospital. To follow-up on payment of outstanding dues with empaneled Corporate/ Institutions. To co-ordinate with Third Party Administrations (TPAs) and follow-up on payment of outstanding dues. To monitor the billing process, time taken for preparation of the final bill. To check the bills on a daily basis. To follow-up on dues from patients in case of default in payment. Training of staff in the department Provide data for Consultants/Doctors payments Defining IP Packages & Tariff and revising them from time to time as per decision of the Management. Any other work assigned by the Management from time to time. Preferred candidate profile Minimum Qualifications Graduate Technical Qualifications Computer Knowledge Minimum 5 to 10 years in relevant experience as IP Manager in Cash & Insurance Billing in hospitals Able to speak local language, English and Hindi

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 Administration, Business Administration, or a related field is preferred for this role.,

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 be part of your role. As the TPA Manager, you will serve as the primary point of contact between healthcare providers and the insurance company. Monitoring the performance of the TPA team and ensuring efficient claim handling will be essential. Managing relationships with multiple hospitals and negotiating terms when necessary are also key aspects of the role. Ensuring compliance with all insurance regulations, industry standards, and internal policies will be crucial. Staying up-to-date with changes in insurance policies and healthcare regulations will be necessary to handle escalated cases and resolve disputes related to claims or policyholder grievances. In terms of team leadership, you will lead, mentor, and manage a team of claim processors and support staff. Conducting regular training sessions on claim processes, industry trends, and regulatory updates will be part of your responsibilities. Monitoring team performance, setting KPIs, and ensuring objectives are met will also fall under your purview. This is a full-time position requiring a total work experience of 10 years. The work location is in person, and the application deadline is 15/10/2024.,

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 having tie up with hospital. To follow-up on payment of outstanding dues with empanelled Corporate/ Institutions. To co-ordinate with Third Party Administrations (TPAs) and follow-up on payment of outstanding dues. To monitor the billing process, time taken for preparation of the final bill. To check the bills on a daily basis. To follow-up on dues from patients in case of default in payment. Training of staff in the department Provide data for Consultants/Doctors payments Defining IP Packages & Tariff and revising them from time to time as per decision of the Management. Any other work assigned by the Management from time to time. Preferred candidate profile Minimum Qualifications Graduate Technical Qualifications – Computer Knowledge Minimum 7 to 10 years in relevant experience as IP Manager in Cash & Insurance Billing in hospitals Able to speak local language, English and Hindi

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.