TPA Coordinator

Job Title: TPA Coordinator
Department: TPA (Third-Party Administrator)
Location: Multispecilaity in Panvel
Salary: ₹15,000 to ₹ 20,000 per month

Job Summary:

A Hospital is looking for a dedicated and detail-oriented TPA Coordinator to join the team. The TPA Coordinator will be responsible for managing the interaction between the hospital and third-party administrators, ensuring smooth processing of insurance claims, and providing support to patients throughout the insurance verification and claim process. This is a full-time position based at our Khanda Colony, Panvel branch.

Key Responsibilities:

• Insurance Verification: Coordinate with insurance companies and third-party administrators to verify patient insurance details, coverage, and eligibility.
• Claims Processing: Handle all aspects of claim processing, including documentation, submission of claims, and follow-up to ensure timely settlement of claims.
• Patient Assistance: Assist patients in understanding their insurance coverage and guide them through the pre-authorization process.
• Data Management: Maintain accurate records of insurance claims, approvals, and denials. Ensure all relevant documentation is available and updated in the system.
• Coordination with Hospital Departments: Collaborate with various hospital departments to gather necessary information for insurance claims and approvals.
• Pre-Authorization: Ensure pre-authorization requests are processed for surgeries, procedures, and hospital admissions as per insurance guidelines.
• Billing Support: Work closely with the billing department to resolve any discrepancies between hospital charges and insurance reimbursements.
• Follow-Up: Follow up with insurance companies regarding pending claims and payment status, ensuring timely resolution.
• Customer Service: Provide excellent service to patients and their families, addressing queries regarding insurance-related matters and resolving any issues that may arise.

Qualifications & Skills:

• Education: Graduate in any stream; a background in healthcare administration or insurance is a plus.
• Experience: Prior experience in TPA or insurance coordination in a hospital or healthcare setting is preferred.
• Skills:
• Strong communication skills (both verbal and written).
• Good organizational skills with attention to detail.
• Ability to work under pressure and meet deadlines.
• Basic knowledge of health insurance policies, procedures, and claim settlement processes.
• Proficiency in MS Office (Word, Excel) and hospital management software.
• Ability to handle sensitive patient information with confidentiality.

Additional Requirements:

• Positive attitude and willingness to work in a team-oriented environment.
• Ability to work flexible hours when necessary, including weekends and holidays.
• Basic understanding of medical terminology is a plus.

Benefits:

• Opportunity to work with a leading hospital in the Panvel region.
• Learning and development opportunities in the healthcare and insurance sector.

How to Apply:

Interested candidates are invited to send their resume to hrmartechsimplified@gmail.com or call at 9873977672.

Job Type: Full-time

Pay: ₹15,000.00 - ₹20,000.00 per month

Work Location: In person