TPA Coordinator

Job Summary:

We are looking for a dedicated and detail-oriented TPA (Third Party Administrator) Coordinator to manage all insurance-related tasks, including pre-authorizations, patient documentation, claim processing, and follow-up with TPA/insurance companies.

Key Responsibilities:

• Coordinate with patients and their families regarding insurance policies and documentation.
• Submit pre-authorization requests to TPAs and insurance providers in a timely manner.
• Follow up on approvals, queries, and rejections from TPAs.
• Handle discharge intimation, final authorization, and e-mail communications.
• Maintain proper records of insurance claims, patient files, and authorization letters.
• Work closely with the billing department for claim settlement and approvals.
• Ensure timely submission of final bills and discharge summaries.
• Handle claim queries and support audits or documentation verifications.
• Keep updated with TPA guidelines and policy changes.
• Coordinate with consultants and hospital departments for necessary medical information.

Skills Required:

• Good communication (English, Hindi, and regional language)
• Familiarity with medical terminologies and hospital systems
• Basic computer skills (MS Office, Hospital Management Software)
• Ability to multitask and handle pressure
• Strong organizational and documentation skills

Preferred Candidates:

• Experience in a hospital/clinic setting with exposure to TPA operations.
• Understanding of IRDAI regulations and healthcare insurance processes.

Job Type: Full-time

Pay: ₹25,000.00 - ₹30,000.00 per month

Work Location: In person