TPA & Mediclaim Executive

Job Description

Job Title: TPA & Mediclaim Executive Location: Indore Salary: ₹20,000 – ₹35,000 per month (based on experience) Job Type: Full-time Job Summary: We are looking for a detail-oriented and efficient TPA & Mediclaim Executive to handle all aspects of insurance claim processing and coordination with Third Party Administrators (TPAs). The ideal candidate will manage the entire lifecycle of patient insurance claims, from admission to final settlement, ensuring timely and accurate processing. Key Responsibilities: Coordinate with TPAs and insurance companies for cashless approvals and claim settlements. Handle patient admission and discharge processes related to insurance. Collect, verify, and submit necessary documentation for claims processing. Follow up on pending claims and ensure timely reimbursement from TPAs. Maintain accurate records of all TPA transactions and communications. Resolve patient and family queries regarding insurance coverage, claim status, and documentation. Work closely with hospital billing, front office, and finance teams to ensure seamless processes. Stay updated on insurance policies, TPA guidelines, and regulatory requirements. Requirements: Minimum 1–2 years of experience in TPA coordination or medical insurance claim processing. Strong knowledge of health insurance policies and claim processes. Good communication and interpersonal skills to handle patients and insurance representatives. Ability to multitask, manage time efficiently, and work in a fast-paced hospital environment. Familiarity with hospital information systems (HIS) is a plus. Educational Qualification: Graduate in any discipline; a background in Hospital Administration or Insurance is preferred. Working Hours: 6 days a week Day shift, with flexibility as per hospital requirements How to Apply: Interested candidates can send their CV Job Type: Full-time Pay: ₹8,086.00 - ₹35,466.78 per month Schedule: Day shift Experience: TPA: 1 year (Preferred) Work Location: In person