TPA Coordinator

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.,