7 Tpa Executive Jobs

Roles and Responsibilities Candidate has to do TPA Empanelment. Candidate will handle entire billing part and documentation. TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. Liaison with Govt. Health Departments. Liaison with Insurance Companies. Tie ups with Corporate Houses. Must be aware of norms of insurance sector. Desired Candidate Profile Good communication. Must have good command over MS Office. Candidate must have experienced in Third party/ Empanelment Corporate tie-ups. Must have experienced of Hospital. Must have Experienced TPA/Cashless/ECHS/CGHS processors. Perks and Benefits Performance based Incentives Interested candidates may share their cv on WhatsApp 8875029935 with be mention Details Total Experience Current City Current Company Home Town Current Salary Expected Salary Notice Period

Adhere billing process guidelines Review claims, Verify coverage Assist with inquiries Prepare claim forms & documents & timely claim processing Record Keeping & upload files on the portal Assist pre-authorizations Resolve billing issues/escalation Required Candidate profile Any graduation or BBA/BHA min. 1 year Billing Experience is preferred Please Email your resume at hr@jimsh.org

Roles and Responsibilities Candidate has to do TPA Empanelment. Candidate will handle entire billing part and documentation. TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. Liaison with Govt. Health Departments. Liaison with Insurance Companies. Tie ups with Corporate Houses. Must be aware of norms of insurance sector. Desired Candidate Profile Good communication. Must have good command over MS Office. Candidate must have experienced in Third party/ Empanelment Corporate tie-ups. Must have experienced of Hospital. Must have Experienced TPA/Cashless/ECHS/CGHS processors. Perks and Benefits Performance based Incentives

Roles and Responsibilities Candidate has to do TPA Empanelment. Candidate will handle entire billing part and documentation. TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. Liaison with Govt. Health Departments. Liaison with Insurance Companies. Tie ups with Corporate Houses. Must be aware of norms of insurance sector. Desired Candidate Profile Good communication. Must have good command over MS Office. Candidate must have experienced in Third party/ Empanelment Corporate tie-ups. Must have experienced of Hospital. Must have Experienced TPA/Cashless/ECHS/CGHS processors. Perks and Benefits Performance based Incentives

Lifepoint Multispeciality Hospital is looking for TPA Executive to join our dynamic team and embark on a rewarding career journey. A TPA (Third Party Administrator) Executive's job description can vary based on the specific company or industry they work in. However, here's a generalized job description for a TPA Executive : Job Title : TPA ExecutiveJob Summary : As a TPA Executive, you will be responsible for managing and overseeing various aspects of third-party administration services for clients. Your primary goal will be to ensure the smooth and efficient processing of claims and other administrative functions while maintaining high levels of customer satisfaction. You will collaborate with internal teams and external stakeholders to deliver exceptional service and meet client expectations. Responsibilities : Claims Management : Handle and process insurance claims efficiently and accurately, adhering to the company's guidelines and relevant regulations. Client Communication : Serve as the main point of contact for clients, addressing inquiries, resolving issues, and providing updates on claim statuses. Policy Administration : Review and validate insurance policy details to ensure correct coverage and policy benefits for claim processing. Documentation and Record Keeping : Maintain accurate records of all claim-related documents, transactions, and communications. Coordination with Healthcare Providers : Liaise with hospitals, doctors, and other healthcare providers to facilitate the smooth processing of medical claims. Network Management : Collaborate with the network management team to maintain a strong network of healthcare providers and negotiate contracts with them. Quality Assurance : Implement and maintain quality assurance processes to ensure accurate and timely claim processing. Reporting : Prepare and present reports on claim processing metrics, performance, and client satisfaction.

Job description A Third Party Administrator (TPA) is a company that provides services to insurance companies and policyholders. A TPA's job description can include:. Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Preparing split bills/ Doctor charges etc. Handling TPA Portals. Outstanding follow-up with TPA. Monthly Review report. To obtain and review referrals and authorizations for treatments. To follow and adhere to all regulations and guidelines set by state programs, and HMO/PPO, etc. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Contact Astha Saklani Contact - 8800506848 HRD Jeena Sikho Lifecare Ltd

Key Responsibility Areas (KRA) Hospital TPA Desk Executive Designation: MDIndia TPA Desk Executive Location: Assigned Hospital Reporting To: MDIndia Provider Management Head Office 1. Claims Processing & Coordination Facilitate the Green Channel process to ensure zero waiting time for patient admissions and discharges. Prioritize and assist with the admission of VIP clients and corporate patients for a seamless experience. Support the end-to-end processing of cashless and reimbursement claims efficiently. Coordinate with the hospital billing and finance team for smooth claim approvals and disbursements. Liaise with the Head Office to resolve claim-related issues promptly. 2. Patient Assistance & Query Resolution Serve as the single point of contact for patients regarding their insurance claims for the specific hospital. Educate patients and their families about the claim process, required documentation, and eligibility criteria . Address and resolve patient grievances related to claims processing, escalating unresolved issues when necessary. 3. Hospital Liaison & Relationship Management Maintain strong professional relationships with hospital administrators, doctors, and billing teams. Collaborate with hospital staff to ensure seamless admission and discharge procedures for insured patients. Conduct regular meetings with hospital management to streamline TPA processes and improve service efficiency. 4. Reporting & Communication Prepare and submit daily/weekly reports on claim status, patient queries, and pending cases to the central office. Communicate any hospital-specific challenges, delays, or process gaps to management for quick resolution. Stay updated with latest TPA policies, regulatory guidelines, and hospital agreements . 5. Fraud Prevention & Risk Mitigation Adhere to strict protocols to prevent fraudulent activities in claims processing. Ensure seamless coordination with the MDIndia Head Office team to mitigate risks. 6. Customer Service & Satisfaction Provide prompt support and clear guidance to insured patients for a positive customer experience. Conduct feedback sessions to identify patient concerns and suggest process improvements. Enhance customer satisfaction by reducing waiting time for admissions, claims, and grievance resolution. 7. Wellness & Value-Added Services Coordination Coordinate with hospital teams for VIP health checkups, doctor consultations, and second opinion arrangements . Organize OPD service arrangements in the hospital for insured patients. Inform the Head Office team about new hospital initiatives and developments. Keep the Head Office updated on competitor processes and industry trends for strategic planning. Key Performance Indicators (KPIs) 1. Turnaround Time (TAT) – Speed of priority admissions and discharges. 2. Claim Accuracy Rate – Number of claims processed without discrepancies. 3. Patient Satisfaction Score – Feedback from patients and hospital staff. 4. Compliance Adherence – Ensuring 100% compliance with regulatory requirements. 5. Hospital Coordination Efficiency – Effectiveness of hospital staff and management liaison. 6. Query Resolution Time – Average time taken to resolve patient/hospital queries. 7. Wellness Service Delivery – Efficiency in coordinating VIP checkups, OPD services, and second opinions.