Tpa Executive

Narayana Health (NH)

1 - 5 years

2 - 3 Lacs

ahmedabad

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Skills Required

tpa health claims mediclaim insurance claims claims management medical insurance health insurance claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Summary

To register new patients under TPA, attend queries, pre-authorization of request, claims, bill recovery.

Job Responsibilities

Handling all debtor receivables,
Solving all queries, which are related to bill.
Checking all IP files before dispatch.
Checking the reasons of cancellation of bill, free bill, discount bill, refund bill.
Preauthorization request will be sent to the respective scheme office for the approval of the concerned treatment (surgical / medical)
Making the changes of packages rates/tests rates as per the Company Agreement.
Maintaining the Debtors aging report for OP & IP
All the inpatient bills will be sent for the claims to the respective scheme office.
Communication with the doctors for any techno-medical clarifications of any query by the TPAs, companies.
Communicate with the TPA customer care for details of the bill.
Communicate with the companies and TPA’s for follow-up on the payments of bills.
Bills recovery.
Interaction with the patients for payments of the dues, which are not made by the TPA or company.
Check the bottlenecks that arise in the payments and solve the problems regarding the bills
Responsible for related to high-value payments to reduce the company’s outstanding liabilities.

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