TPA Coordinator

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.

Job Types: Full-time, Permanent

Pay: Up to ₹18,000.00 per month

Benefits:

• Provident Fund

Work Location: In person