Tpa Coordinator

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A TPA (Third-Party Administrator) Executive manages health insurance claims, pre-authorizations, and billing between patients, hospitals, and insurance companies. Key duties include verifying coverage, processing cashless/reimbursement claims, updating TPA portals, and ensuring timely claim settlements while providing customer service to patients.

Key Responsibilities

• Claim Processing: Handling cashless claim processes from admission to discharge, including preparing bills, updating implants, and reconciling accounts.
• Pre-Authorization: Obtaining and reviewing approvals for planned treatments and surgeries from insurance providers.
• Documentation & Portals: Maintaining accurate medical records, scanning documents, and managing TPA portals for updates.
• Coordination: Acting as the primary liaison between patients, hospital staff, and insurance companies for smooth service delivery.
• Patient Support: Advising patients on insurance benefits, coverage limits, and resolving queries regarding claims.

Required Skills and Qualifications

• Experience: Freshers Can Apply.
• Education: Bachelor’s degree in any discipline.
• Knowledge: Strong understanding of insurance policies, guidelines, and medical terminology.
• Technical Skills: Proficiency in TPA portals and hospital information systems (HIS).
• Communication: Excellent interpersonal skills to handle patient counseling and insurance coordination.

Job Types: Full-time, Permanent

Pay: ₹12,000.00 - ₹15,000.00 per month

Benefits:

• Paid sick time
• Paid time off
• Provident Fund

Ability to commute/relocate:

• Kalyan, Maharashtra: Reliably commute or planning to relocate before starting work (Required)

Experience:

• TPA AT HOSPITAL: 1 year (Required)

Work Location: In person