TPA Manager Hospital

Role Overview

The TPA (Third Party Administrator) Manager will be responsible for managing all insurance-related processes in the hospital, ensuring smooth coordination with TPAs, insurance companies, patients, and internal hospital teams. The role requires strong knowledge of healthcare insurance processes, cashless approvals, claims settlement, and regulatory compliance.

Key Responsibilities

• Manage cashless admission & discharge processes by coordinating with TPAs and insurance companies.
• Ensure timely pre-authorization approvals and enhancement requests for patient treatment.
• Handle claim documentation, submission, and follow-up for faster settlement.
• Maintain strong working relationships with TPAs, insurance officials, and internal hospital departments.
• Resolve disputes, denials, or queries related to claims.
• Keep updated records of insurance patients, approvals, billing, and settlement status.
• Train and guide hospital staff on insurance-related procedures and documentation.
• Ensure compliance with IRDAI guidelines and hospital SOPs.
• Generate daily/weekly/monthly reports on insurance billing, approvals, and receivables.

Requirements

• Graduate / MBA (preferred) with 3–7 years of experience in hospital TPA/insurance desk management.
• Strong knowledge of cashless process, claims cycle, and insurance documentation.
• Excellent communication and coordination skills with TPAs, patients, and internal teams.
• Ability to handle pressure, resolve disputes, and ensure faster turnaround.
• Proficiency in MS Office, hospital billing systems, and TPA portals.

Compensation

Competitive salary as per industry standards + performance incentives.

Job Type: Full-time

Pay: ₹20,000.00 - ₹65,569.11 per month

Work Location: In person