407 Tpa Jobs - Page 17

TPA Liaison: Serve as the primary point of contact between the hospital and TPAs, ensuring smooth claims processing and reimbursement. Collaborate with TPAs to verify patient eligibility, approve pre-authorizations, and facilitate smooth discharge procedures. Ensure timely submission of claims, follow up on outstanding claims, and resolve any discrepancies or issues related to TPA reimbursements. Corporate Client Coordination: Act as a liaison for corporate clients, addressing their queries and ensuring employees medical needs are met efficiently. Coordinate with corporate clients to manage employee health programs, including corporate insurance policies, wellness programs, and preventive health check-ups. Assist in the onboarding of corporate clients and ensure smooth setup for hospital services under corporate agreements. Claims Management: Monitor, track, and process claims submitted by patients under TPA and corporate agreements. Ensure all claims meet the required documentation and regulatory standards. Resolve claim issues and disputes in a timely manner, coordinating with both internal departments and external stakeholders. Documentation and Reporting: Maintain accurate records of all communications, claims, approvals, and payments from TPAs and corporate clients. Prepare regular reports on claims processing status, pending approvals, and financial reconciliations for internal and external stakeholders. Ensure all documentation is organized, up-to-date, and compliant with hospital policies and industry regulations. Customer Service: Provide exceptional customer service to patients, TPAs, and corporate clients by addressing inquiries and concerns promptly. Ensure patients and their families understand the process of claiming insurance and managing payments through TPAs or corporate policies. Cross-Functional Collaboration: Work closely with the billing, finance, and medical teams to ensure that patient care is seamless, and claims are processed efficiently. Collaborate with other hospital departments (admissions, discharge, accounts) to resolve any patient-related issues concerning TPA and corporate coverages. Compliance and Regulations: Stay updated with the latest regulations, policies, and procedures related to TPAs, corporate healthcare programs, and insurance claims. Ensure all processes align with the hospitals standards, legal requirements, and industry best practices. Key Skills and Qualifications: Education: Bachelors degree in healthcare management, business administration, or related fields. Experience: 1-2 years of experience in TPA management, corporate healthcare coordination, or insurance claims processing is preferred. Skills: Strong communication and interpersonal skills to interact with TPAs, corporate clients, and internal teams. Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and hospital management systems. Ability to handle sensitive and confidential patient information. Attention to detail and strong organizational skills to manage multiple tasks simultaneously. Problem-solving skills to resolve claims and coordination issues. Working Environment: The role typically operates in an office setting within the hospital or remotely, with periodic visits to patient care areas or meetings with external stakeholders. The job may involve working with insurance companies, corporate representatives, and patient families, requiring professional demeanor and strong customer service skills.

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

Post: Billing Sr. Executive/ Executive, OPD/IPD Billing, Patient Care Executive, Front Office Executive Hospital Name: Batra Heart & Multispeciality Hospital, Sector-31, Faridabad Qualification: Graduation Experience: Minimum 2 Years of Experience (Hospital / Healthcare Experience is Must) Gender : Male/Female Interview Time: 11am to 4pm Candidates can attend walking interview at the hospital location at Batra Heart and Multispeciality Hospital, spring Filed Colony, Sector 31, Faridabad. Or send their CV at hr@batrahealthcare.com (with Current Salary & expected salary) Job Description: Preparing final billing during patient discharge Responsible for patient admission & IPD Billing, Patient Investigation Billing,, Good knowledge of patient procedures, doctor visits, specialty charges etc. Daily follow up with the patients for payment Assessing the billing for rich amount Preparing and submitting billing data and medical claims to insurance companies. Ensuring the patients medical information & Billing is accurate and up to date. Preparing bills and invoices, and documenting amounts due for medical procedures and services. Collecting and reviewing referrals and pre-authorizations. Monitoring and recording late payments. Following up on missed payments and resolving financial discrepancies. Examining patient bills for accuracy and requesting any missing information. Investigating and appealing denied claims. Helping patients develop patient payment plans. Maintaining billing software by updating rate change, cash spread sheets, and current Good knowledge in on line payments like Google, paytm, direct account, credit cards etc. Analyzing the bill summary, payment terms in mid of treatment Good knowledge in TPA, Panel, and Govt. panels, ECHS, CHHS etc. Computer knowledge is must. HIS software knowledge must Good communication good knowledge of patient handling, counselling & Patient care Thanks & Regards HR Team

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

Immediate job openings for Doctor's with Star Health & Allied Insurance No. of open positions: 20 nos. Location: Royapettah, Chennai Job description Honour the clients and ready to provide the best consultation Handling customer queries and clarifying claims related Ensure safekeeping of the client records Responsible for handling problem of the clients in a highly professional manner Experience in Medi-claims processing Qualification: BDS / BAMS / BHMS / BSMS / MBBS / MDS / BPT / NMD Experience: Fresher / Experienced in handling TPA medical claims Languages to be known: Tamil / English / Hindi Contact details: HR Sangeetha Email Sangeetha.karthik@starinsurance.in Interested candidates walk-in Walk-in Details: Star Health and Allied Insurance Co. Ltd., # No 15, Ground Floor, Sri Balaji Complex Whites Lane, Royapettah Chennai - 600014. Landmark: Behind Sathyam Theater

Investigate health insurance claims, verify medical records, detect fraud, conduct field visits, and prepare detailed reports. Coordinate with hospitals and ensure compliance with TPA policies and IRDAI guidelines. Medical background preferred.

Role & responsibilities To go through the bill and counselling on the approximate cost of the treatment in consensus with the treating consultant. To give the interim bill update day to day and explain the details of the bill and signature of the same need to be done. Ensure that the payment is done post counselling according to the bill amount and treatment procedures. Ensure transparency in billing. Keep a track on the TATs defined and adhered to the same Maintain good interpersonal relationships with Doctors , Patients , Corporate Representatives and other departments Preferred candidate profile Candidate should have Any degree qualification. Candidate should have min 1 year Hospital Industry. Both Male & Female can apply for this post.