TPA & Mediclaim Executive

You are a detail-oriented and efficient TPA & Mediclaim Executive responsible for managing insurance claim processing and coordination with Third Party Administrators (TPAs). Your primary role involves overseeing the entire lifecycle of patient insurance claims, from admission to final settlement, ensuring accurate and timely processing. Your key responsibilities include coordinating with TPAs and insurance companies for cashless approvals and claim settlements, handling patient admission and discharge processes related to insurance, collecting, verifying, and submitting necessary documentation for claims processing, following up on pending claims, maintaining accurate records of all TPA transactions, resolving patient and family queries regarding insurance coverage, claim status, and documentation, and working closely with hospital billing, front office, and finance teams to ensure seamless processes. Additionally, staying updated on insurance policies, TPA guidelines, and regulatory requirements is essential. To excel in this role, you should have a minimum of 12 years of experience in TPA coordination or medical insurance claim processing, possess strong knowledge of health insurance policies and claim processes, demonstrate good communication and interpersonal skills, exhibit the ability to multitask, manage time efficiently, and work in a fast-paced hospital environment, and ideally be familiar with hospital information systems (HIS). As an ideal candidate, you are a graduate in any discipline, with a background in Hospital Administration or Insurance being preferred. The working hours are 6 days a week, with a day shift and flexibility as per hospital requirements. If you meet the requirements and are interested in this position, please send your CV for consideration.,