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For Employers

TPA Executive

Nakshatra Skill Development Campus PVT.LTD

1 years

2 Lacs

india

Posted:1 day ago| Platform: GlassDoor logo

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Skills Required

coordination authorization billing documentation reports reimbursement resolve

Work Mode

On-site

Job Type

Full Time

Job Description

Post: TPA Executive
Location: KhargharQual: Any GraduateExp: Minimum 1 year exp in Hospital TPAShift: DaySalary: 23K

TPA Coordination & Approvals

Handle cashless treatment approvals and coordinate with respective TPAs.
Submit required documents for pre-authorization and final authorization.
Track approval status and follow up with insurance/TPA provider as needed.

Billing & Documentation

Prepare and verify patient bills for TPA/insurance claims.
Ensure accurate documentation, including discharge summaries, invoices, reports, etc.
Upload/submit claims on TPA portals and maintain proper filing.

Patient Assistance

Guide patients and their families about TPA procedures and required documents.
Assist patients with cashless and reimbursement processes.
Address patient queries related to insurance coverage.

Coordination With Internal Teams

Work closely with billing, admission, discharge, and medical records departments.
Communicate with doctors for necessary medical justification or clarifications.

Claims Follow-up & Settlement

Track claim status and follow up for pending or rejected claims.
Resolve discrepancies or disputes with insurance companies/TPAs.
Maintain MIS reports for daily operations and claim status.

Job Type: Full-time

Pay: ₹18,000.00 - ₹23,000.00 per month

Benefits:

Food provided

Work Location: In person

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