406 Tpa Jobs - Page 5

Medical Typist Location : Greater Noida Designation : Medical Typist Department : TPA Qualification : Any Graduate Experience : 1-3 years experience in Pathology/ Radiology/ Report Typing Job Description : Pathology/ Radiology/ Report Typing Skill Required : Relevant Notes : Full Time Job Submit

Qualification: Any Graduate Experience: 8-10Years Must have worked for TPA / Corporate/ PSU/Referral Marketing Contact: HR Department Email : www.umkalhospital.com Mo. : 8860077509,7988561761

We are hiring TPA Manager for very reputed hospital in Delhi location. Need min 10 years experience & well versed with the following:- TPA Empanelment (visit in TPA and Insurance companies) Co-ordination with OPD/IPD Department (Admission & Discharge of cashless patient) Processing all the co-ordination activities from cashless patient's admission to discharge. Counselling the patient's family to explaining the pre-auth process. Maintaining & uploading patient's files on the portal. Handling all TPA Portals. Maintaining separate file for every patient with highlight co-payment and authorization letter. Telephonic follow up to the insurance company for conveniently claim settled. Maintaining daily MIS outstanding sheet of TPA patients. Prepare month wise MIS sheet for cashless settlement claim. Follow-up with TPA for outstanding payment. Handling all processes related to billing and TPA IPD Billing for (Cash and Cashless patients) Interested candidate can contact us on 8851627720 or Email at srservices2510@gmail.com

Manage end-to-end claims process for corporate insurance policies (GMC, GPA, WC, Fire, etc). Coordinate with clients, insurers, and TPAs to ensure timely documentation and settlement . Track claim status and provide regular updates to clients. Analyze claim patterns and support clients with insights and loss mitigation strategies. Ensure service level agreements (SLAs) are met and maintain claim MIS reports. Assist clients during audits or investigations, where required. Requirements: Minimum 2 years of experience in corporate insurance claims handling. Strong understanding of Group Mediclaim , GPA , and WC policies. Excellent communication and client coordination skills. Organized, detail-oriented, and comfortable handling multiple cases. Knowledge of insurer and TPA claim portals is a plus.

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated. Key Responsibilities Ensure all reimbursement and cashless claims are processed within the committed TAT across clients. Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps. Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients. Collaborate closely with the customer success and insurance teams to address claim escalations proactively. Drive continuous process improvement in claims handling and communication workflows. Maintain internal dashboards and reports to track SLAs and spot trends. Requirements 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred). Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines. Assertive communicator with negotiation skills to handle TPAs and insurers. Analytical mindset with ability to identify patterns in delays or rejections. Empathy for the end user the employee or HR dealing with a health issue. Why Join Pazcare? Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits. Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale. Be part of a culture that values transparency, speed, and customer-first thinking.

Roles and Responsibilities Manage team performance, ensuring timely completion of tasks and projects. Conduct audits, rate analysis, package management, policy issuance, and negotiations with clients. Develop strong coordination skills to ensure effective communication among team members. Identify areas for improvement and implement process enhancements to increase efficiency. Collaborate with cross-functional teams to achieve business objectives. TPA EXperience will be preffered.

Job Title : CRM Manager TPA Industry Industry : Health Insurance / Third Party Administration Role Objective To lead and optimize the organizations CRM strategy, ensuring seamless client interactions, data integrity, and service delivery across health insurance workflows. The CRM Manager acts as a bridge between technology, client servicing, and operational teams to enhance customer satisfaction and retention. Key Responsibilities Functional Area RM Strategy & Execution - Design and implement CRM strategies aligned with business goals - Drive customer engagement, retention, and satisfaction initiatives Client Data Management - Ensure accurate and secure client data entry and maintenance - Monitor data quality, segmentation, and compliance with IRDAI norms System Optimization - Oversee CRM platform performance - Coordinate with IT for upgrades, integrations, and troubleshooting Cross-Functional Collaboration - Work closely with Claims, Preauth, Customer Care, and Enrollment teams - Align CRM workflows with service delivery and escalation protocols Reporting & Analytics - Generate dashboards and reports on client interactions, SLAs, and service metrics - Analyze trends to identify service gaps and improvement areas Training & Adoption - Train internal teams on CRM usage and best practices - Promote CRM adoption across departments for consistent client experience Stakeholder Engagement - Coordinate with brokers, insurers, and corporate clients for feedback and service alignment - Support renewal cycles and client onboarding through CRM tools. Skills & Competencies Strong understanding of health insurance and TPA operations Proficiency in CRM platforms and data analytics tools Excellent communication and stakeholder management skills Strategic thinking with a customer-first mindset Ability to lead cross-functional initiatives and drive adoption Experience Required 5-9years in CRM management, client servicing, or operations within the TPA or Health Insurance domain Prior experience in handling enterprise clients and managing CRM implementations is preferred. Interested Candidate can connect -09971006988

Designation-Executive/Team Lead in CRM for Client Servicing for Big Corporate. Location: Ludhiana, Punjab Industry-TPA Company or Health Insurance will only be preferred Job Description: Key Responsibilities Functional Area Responsibilities Client Management & Retention - Lead the retention and engagement strategy for top corporate clients in the region - Work closely with the servicing team to ensure consistent delivery and relationship strengthening Leadership Reporting - Review reports on corporate clients, insurance companies, and brokers with senior leadership - Identify potential service gaps and resolve proactively before escalation SLA Fulfillment - Monitor and ensure adherence to agreed SLAs across all client touchpoints - Address gaps promptly and implement corrective actions MIS Oversight - Ensure timely and accurate submission of MIS reports to corporates and insurance partners - Validate data integrity and presentation quality Departmental Function Oversight - Oversee functioning of Customer Care, Claims, Preauth, and related operational units - Ensure seamless coordination and issue resolution across departments Claims & Cashless Settlement - Monitor end-to-end claims and cashless processes for assigned clients - Ensure smooth settlements within timelines and policy terms Stakeholder Coordination - Coordinate with brokers, insurance companies, and corporate clients for daily operations and strategic alignment - Manage escalations, feedback, and service refinements collaboratively Experience Required 35 years of hands-on experience in Customer Service or Client Relationship Management roles within the Health Insurance or TPA sector Proven expertise in handling key accounts and leading cross-functional collaboration Strong understanding of insurance workflows, claims processing, and regulatory nuances Interested Candidate can connect -09971006988

Responsibilities: Ensure timely claim settlements within policy limits. Manage health claims from intake to payment. Process mediclaim & TPA claims with accuracy. Collaborate with insurers on claim resolution. Health insurance Annual bonus

Minimum 1 year of Medical Coding Experience. Strong Knowledge on coding appropriate ICD s, CPT s and HCPC Codes. Strong Knowledge to ensure in assign codes based on coding and customer guidelines. Hands - on Knowledge in CCI edits, LCD, NCD coverage determination etc Strong Knowledge in Medical terminology, Human Anatomy and Physiology Knowledge of coding all CPT s related to Simple Procedures - Both Pro/ Fac Laceration repair Incision and Drainage Foreign body removal Splint Fracture reduction Nail Procedures Epistaxis Cerumen Impaction removal Moderate Sedation Procedure Blood Transfusion Foley/ Straight Cath Placement Bladder Scan Fracture Care Intraosseous Line Placement TPA for Stroke PICC Lines Colposcopy Burn care Critical care guidelines for both Professional/Facility, Carve out time guidelines. Critical Care drugs/ Procedures - Both Pro/ Fac CPR Intubation Central Line Placement Cardioversion Chest tube insertion Thoracotomy Tracheostomy Insertion Pacemaker Insertion ED Facility - Infusions + Injections : Hierarchy of injection, infusion, and Hydration guidelines Vaccination coding Drugs given for procedures like CPR, intubation cannot be captured separately Hydrations will be captured at any rate unless documented as TKO or KVO. Do not capture if listed as TKO or KVO Hydration given at the same time as a blood transfusion/ Infusion of any drug- The hydration charge will not be captured unless the documentation supports the administration of the hydration was in a different site. Dx to cover medical necessity of hydration Modifiers. Sound Knowledge on modifiers (XU, 52,53, 76, 77 .) Location specific modifiers Strong in level of service determination with 1995 & 1997 documentation guidelines and should have proficiency in ED Profee/ Facility ACEP point calculation. Strong knowledge in Observation service coding Maintaining a quality threshold of 97% and meeting the client expectations. Maintaining 100% production from day 1 (per ramp)

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. • • • Responsibilities Understand the process difference between PA and an RI claim and verify the necessary details accordingly. • Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff. • • Approve or deny the claims as per the terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai/Bangalore Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. • • • Responsibilities Understand the process difference between PA and an RI claim and verify the necessary details accordingly. • Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff. • • Approve or deny the claims as per the terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Join our dynamic international business team across Bangalore and Hyderabad Job Description Claims Service Support (CSS) - AM/Manager Summary: We at Prudent Insurance Brokers, are seeking an experienced Employee Benefit-Claims Service Support professional for our International Business (IB) vertical. Employee Benefits Practice at Prudent is a strategic business unit dedicated to strengthening Prudent’s global brand in the international market. The individual will be responsible to Serve as primary point of contact for all employee claim queries etc. We are committed to delivering bespoke Benefit & Total Reward Solutions with high standards of service excellence, world-class advisory and consultancy support for MNC clients who have their operations in India. Our team forms a bridge of trust between the expectations of senior stakeholders globally and the seamless delivery of these best practices in India. Roles & Responsibilities: • 1) Exceptional Employee Experience Support system by Prudent Serve as primary point of contact for all employee claim queries and own the process of developing strong employee relationships & engagement 2) Facilitating the cashless and reimbursement process: Ensuring employees understand the steps involved in both cashless and reimbursement claims. Offering exceptional support and guidance to employees/HR throughout the entire process to ensure a smooth experience. 3) E-cards/network hospitals: To provide employees e-cards and information about network hospitals. 4) Providing claim-related queries: Addressing questions about claim status, claim deductions, and explanations of queries. 5) TPA Co-ordination: Co-ordinating with TPA daily to ensure the smooth functioning of employee-related queries 6) Employee Engagement & Support SPOC: Daily tracking of claims on status/rejections/deductions and providing the report to MCS Desired profile/who should join: Good listening & communication skills Should have good technical knowledge about Employee health Insurance/ General Insurance products. (Cashless/Reimbursements) Experience in General Insurance/ Insurance Brokers Years of experience: 2 to 5 years Education qualification: Bachelor's Degree, Master's Degree Good knowledge of the TPA/Insurance processes Well-versed in health insurance policy conditions Well-versed with current medical practices & advancements Should know about IRDAI health regulation If the opportunity interests you, kindly share your updated CV with Tanay Srivastava (tanay.srivastava@prudentbrokers.com) or Yogesh Nagar (Yogesh.nagar@prudentbrokers.com) with the subject ‘’Claims role_*Location*’’ Role & responsibilities

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Jun 3, 2025 Bangalore, India, 560064 Who we are The opportunity Responsible for General Ledger, Intercompany including but not limited to General Ledger transactions, Support Balance sheet review, Intercompany reconciliations preparation, Billing and compliance with internal and business controls. Communication and (internal) stakeholder management with higher management levels within the Global Teva organization is required in this process. How you ll spend your day Technical/functional knowledge in Intercompany Accounting, Closing and reporting process area Handle various types of intercompany transactions such as sales of products, Transfer pricing agreement (TPA) transactions, services, inventory sales/purchases, cost allocations, royalties, Inhouse banking transactions. Ensure that accruals are properly recorded and analyzed Preparation of Journal Entries & Supporting schedule Perform Support monthly and quarterly close activities of multiple entities Analysis of the various accounts and variances per legal entities, obtain explanation on deviations and prepare a summarized reporting on a monthly basis within scheduled time Preparation monthly Intercompany reconciliations & clearance of reconciling/aged/disputed items. Hands on experience in submission of trial balance in HFM. Identify & drive process improvement, standardization opportunities in of processes and tasks across the team. Acting as a key contact for local teams for record-to-report related questions Ensuring that accounting books and records comply with accounting policies and regulations Provide supporting documents and explanations for all internal and external audit as and when required Knowledge on Accounts payable (AP) and Accounts receivable (AR) books. Your experience and qualifications University education in Accounting or Finance required Masters degree is preferred Minimum experience of 6+ years of closing & reporting, Intercompany experience Preferably familiar with USGAAP Working knowledge of internal controls Good working knowledge of SAP Good understanding of accounting processes and can follow accounting policies Good analytical skills and have hands on experience on working & clearance of reconciling items Fluent verbal and written communication in English Experience in a multinational firm or within a GBS (Global Business Service) is preferred Hands-on and proactive; strong organizational skills Sr Mgr Finance Operations Already Working @TEVA The internal career site is available from your home network as well. If you have trouble accessing your EC account, please contact your local HR/IT partner. Teva s Equal Employment Opportunity Commitment Teva Pharmaceuticals is committed to equal opportunity in employment. It is Tevas global policy that equal employment opportunity be provided without regard to age, race, creed, color, religion, sex, disability, pregnancy, medical condition, sexual orientation, gender identity or expression, ancestry, veteran status, national or ethnic origin or any other legally recognized status entitled to protection under applicable laws. We are committed to a diverse and inclusive workplace for all. If you are contacted for a job opportunity, please advise us of any accommodations needed to support you throughout the recruitment and selection process. All accommodation information provided will be treated as confidential and used only for the purpose of providing an accessible candidate experience.

Greetings from Vidal Health Insurance TPA Pvt Ltd., Openings For District Medical Officer!!! - Non Clinical Role,Immediate Joiners Preferred Qualification -MBBS(FMG - Non MCI)/BDS Experience - 0 to 1 Year Job Location - Chennai Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals. Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of the Customers about the respective Claim/Preauth. Play as an intermediate role between the Insurance co., and the Customer. Handling Customer queries and giving a prompt reply to the customers through email. Preparing the Weekly consolidated reports of the team and updating to the Management. Assigning and Resolving Customer Queries through email. Raising Shortfall whenever it is necessary. Approving and Rejecting of Claim/Preauth after all necessary checks I nterested Candidates can Whatsapp(no calls please ) your resume to Udaya Kumar R - 9940138034 or Apply in Naukri Itself. Regards Udaya Kumar R 9940138034

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work From Office only Interested candidates can share their CVs to Dona- 9632777628

I am hiring for this position for one of our Life Insurance clients. Role & responsibilities Prudent claim Assessment and management of end-to-end claim settlement /repudiations, including Life, Group claims Coordinate with Reinsurers /sales/customers for closure of claims within the regulatory framework and timelines Direct and oversee the maintenance of complete and accurate claim management records. Managing the claim teams on day-to-day claims transactions, guidance on claims philosophy, regulatory, and audit procedures Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality Ensure customer centric approach while delivering sensitive area of death claims. Accuracy and Speed in delivery Customer satisfaction Quality in claims assessment/approvals Preferred candidate profile Graduate with required communication skills, A minimum of five to seven years progressively responsible previous insurance industry experience. Life Insurance domain knowledge Decision-making skills. MIS, MS Excel, Workflows , Group Asia and Life Asia system knowledge

Roles and Responsibilities 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage Financial : To see to that there is no financial implication for the organization while settlement of claims Role : Medical Officer Required Knowledge /Skill : Clinical / TPA /Medical knowledge with insurance background Education : MBBS Working timing: Morning Shift / General Shift / Afternoon Shift / Evening Shift Job Location : IBC Knowledge Park, 4th Floor, D Block, Dairy Circle, Bannerghatta Road, Bangalore Note : This position is for Working from office only. Please do not apply if you are looking for working from home. Job Type: Full-time Work Location: In person,

The candidate must have completed BHMS, BAMS, or BUMS from a reputed university." Experience : 0 to 2 years Locations : Bangalore, Chennai and Mumbai / Pune Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-quality patient care at customized/optimized cost. Creating the process for claim processing (Cashless and Reimbursement). Preferred candidate profile • Good Excellent oral and written communication, negotiation, and decision-making skills. • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities . Must be willing to work in non - clinic

Job Title: Billing Incharge - Hospital Billing & Claims Location: Moradabad Department: Billing Reports To: Hospital Administrator / Finance Manager About Hospital: The Siddh Multispeciality Hospital is established by Dr. Anurag Mehrotra, MD, DM, FACC, FESC a renowned figure in the field of cardiology for last twenty years. We have been able to achieve NABH (Complete) & ISQUA (For International Patients) Accreditations in short span of time. Hospital also got accreditation with NBEMS for DNB courses. Siddh Hospital is tertiary Care hospital known for its cardiac & intensive care. Hospital also excess in equipped departments like gastro surgery, minimal invasive surgery, ortho & neurosurgery, maternity care, paediatrics, nephrology and others. Job Summary: We are looking for an experienced and detail-oriented Billing Incharge to lead and oversee the hospital s billing operations. The ideal candidate must have strong expertise in TPA (Third Party Administrator) / Insurance billing and Ayushman Bharat (PM-JAY) scheme billing. The role involves end-to-end billing management, claims processing, coordination with TPA/insurance companies, and ensuring timely and accurate revenue realization. Key Responsibilities: Supervise day-to-day billing operations across cash, credit, TPA, and government schemes . Ensure accurate and timely pre-authorization, claim submission, and follow-ups with TPAs and insurance companies. Handle Ayushman Bharat (PM-JAY) beneficiary verification, package selection, and e-card generation. Ensure compliance with Ayushman Bharat billing protocols , empanelment terms, and timely claim settlement. Coordinate with medical, nursing, and diagnostic teams to gather all documentation required for claim processing. Resolve queries related to claims rejection, short payments , and discrepancies in coordination with TPAs and government portals. Prepare and review MIS reports on billing, pending claims, collections, and rejections. Maintain accurate and organized billing records and audit trails for internal and external audits. Ensure team adherence to SOPs, turnaround times (TATs) , and revenue cycle management goals. Train and supervise billing staff and ensure high standards of customer service and compliance. Qualifications & Skills: Graduate or Postgraduate in Commerce, Healthcare Administration, or related field. Minimum 3-5 years of experience in hospital billing with hands-on experience in TPA/insurance and Ayushman billing . Strong knowledge of hospital billing software (e.g., HIS systems) and online claim portals (ROHINI, PM-JAY, etc.). Familiarity with medical terminology, hospital packages, coding (ICD/CPT) , and insurance procedures. Excellent problem-solving, communication, and interpersonal skills. Ability to work under pressure and meet strict timelines. Preferred Qualifications: Certification in Medical Billing or Health Insurance Claims Processing . Experience with state health schemes and public-private partnership billing . Salary: As per industry standards Work Type: Full-time