TPA & Government Panel Settlement Executive

Rungta Hospital

2 - 5 years

2 - 4 Lacs

jaipur

Posted:2 weeks ago| Platform:

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Skills Required

claim settlement health claims mediclaim claims hospital health insurance claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Handle claim submission, follow-up, and settlement with TPAs and government panels.
Track outstanding payments and prepare periodic reconciliation reports.
Coordinate with TPAs, insurance companies, and internal departments for claim clarifications.
Maintain records of claims, payments, and rejections in both Excel and Tally.
Post settlement entries, adjustments, and payment receipts in Tally.
Prepare monthly outstanding and collection status reports for management review.
Ensure timely submission of required documents for pending claims.
Follow up on delayed or short payments and resolve discrepancies.
Maintain communication logs and documentation for all settlement activities.
Support audit and compliance requirements related to TPA and panel accounts.

Preferred candidate profile

Bachelors degree in Commerce, Finance, or a related field.
Minimum 2–4 years of experience in hospital billing, TPA coordination, or account settlement.
Proficiency in
Tally ERP
and MS Excel.
Good knowledge of TPA/Government panel processes (CGHS, ECHS, ESIC, etc.).
Strong communication and coordination skills.
Attention to detail and ability to manage multiple accounts efficiently.

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