TPA Coordinator

Job Title: Cashless / TPA Executive

Location: [Navrangpura / Naranpura] – Solar Multispecialty Hospital
Department: Cashless / TPA
Experience: Minimum 1 year in a hospital handling TPA / cashless process
Qualification: Graduate (preferably in Commerce, Hospital Administration, or related field)

Key Responsibilities:

• Coordinate with Third-Party Administrators (TPAs) and insurance companies for cashless approvals and claims.
• Handle admission intimation, pre-authorization requests, and timely follow-ups for approvals.
• Ensure accurate and complete documentation as per TPA and insurance norms.
• Liaise with consultants for timely preparation and submission of discharge summaries and final bills.
• Obtain final approvals from TPAs/insurance before discharge.
• Maintain and update TPA tracking registers and online portals daily.
• Educate patients/attendants regarding the cashless process and requirements.
• Follow up for pending approvals, shortfalls, and documentation requirements.
• Ensure all claim-related documents are properly scanned and filed for audit and reimbursement.
• Coordinate with internal billing, medical records, and operations team to ensure smooth processing.
• Maintain good relationships with TPA coordinators and insurance desk partners.

Skills & Competencies:

• Strong understanding of health insurance processes and TPA workflows.
• Good communication and interpersonal skills.
• Proficiency in MS Office and hospital information systems (HIS).
• Ability to handle pressure and multitask in a hospital environment.
• Attention to detail and strong documentation skills.

Job Type: Full-time

Pay: ₹10,000.00 - ₹35,000.00 per month

Benefits:

• Food provided
• Leave encashment

Work Location: In person

Expected Start Date: 25/07/2025