TPA Coordinator

Hi,

We are Vitraya Technologies Private Limited, an IT product-based company specializing in delivering innovative software solutions to the insurance industry. Given our focus on the insurance sector, we require professionals with a medical background or a strong understanding of medical terminology and procedures.

We invite individuals who have completed medical-related courses such as Nursing BDS, MDS,FDS or an Insurance TPA Background, MBBS and are looking to transition from a clinical setting to a corporate environment.

Job Summary

We are seeking a TPA Coordinator with sound medical knowledge to act as a liaison between hospitals, TPAs, and insurers. The role focuses on managing pre-authorization and claims documentation while ensuring compliance with medical and policy guidelines.

Key Responsibilities

• Coordinate with hospitals for pre-authorization and claim documentation
• Review and validate medical records and treatment details submitted by hospitals
• Ensure completeness and accuracy of claim files before submission
• Follow up with hospitals for pending medical or billing documents
• Support claim settlement by clarifying medical queries and policy conditions
• Maintain records of claims, approvals, denials, and escalations
• Assist in resolving claim-related issues between hospitals and insurers
• Ensure adherence to TPA and insurer SOPs

Required Skills & Medical Knowledge

• Strong understanding of medical terminology, procedures, and hospital billing
• Knowledge of health insurance claims process and pre-authorization
• Ability to review clinical documents and discharge summaries
• Good coordination, follow-up, and communication skills
• Basic computer skills (Excel, hospital portals, TPA systems)

Educational Qualification

• Graduate in Nursing / Pharmacy / Life Sciences / Healthcare Management
• Experience working in hospital TPA desk or insurer claims team is preferred

Your role will be crucial in ensuring the integrity and accuracy of medical claims, contributing to a streamlined and efficient claims process for our clients.

Job Type: Full-time

Benefits:

• Food provided
• Health insurance
• Provident Fund

Work Location: In person

Interested Candidates can apply at [email protected] or WhatsApp their resume at9999043348. Kindly mention “Applying for TPA Coordinator” while applying on email or sending it to WhatsApp along with your CV attached.

Job Type: Full-time

Pay: ₹25,000.00 - ₹35,000.00 per month

Benefits:

• Food provided
• Health insurance
• Provident Fund

Education:

• Doctorate (Required)

Work Location: In person