Tpa Manager

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Job Opening: TPA Manager

We are looking for an experienced and driven TPA Manager to oversee our insurance claim processing, hospital empanelment, and cashless hospitalization operations. The ideal candidate will have a strong background in healthcare insurance management, excellent coordination skills with hospitals and TPAs, and a track record of reducing claim rejection rates while ensuring smooth patient experience.

Position Overview

- Role: Manager (TPA)

- Location: Patna, Bihar

- Experience Required: 3–6 years in TPA operations, health insurance, or hospital billing/insurance desk

- Education: Graduate in any discipline; MBA in Healthcare/Insurance or BBA preferred

- Compensation: ₹30,000 – ₹35,000 per month (Depending on experience)

Key Responsibilities

1. TPA Coordination & Empanelment

- Liaise with TPAs, insurance companies, and corporate clients for cashless approvals.

- Manage hospital empanelment process with new TPAs and insurers to expand network.

- Negotiate tariffs, packages, and credit terms to maximize hospital revenue.

2. Claims & Billing Management

- Oversee end-to-end claim lifecycle: pre-auth, documentation, submission, follow-up, and settlement.

- Ensure accurate and timely filing to minimize rejections and deductions.

- Conduct regular audits of processed claims and maintain zero pendency reports.

3. Operations & Patient Support

- Analyze TPA data to track claim TAT, approval ratios, and revenue leakage.

- Supervise and train the insurance desk team on documentation and IRDAI guidelines.

- Ensure absolute compliance with IRDAI regulations, insurance protocols, and hospital SOPs for cashless treatment.

Required Skills & Qualifications

- Technical Knowledge: Deep understanding of health insurance policies, ICD codes, tariff structures, and major TPA/insurance workflows in Bihar.

- Software Skills: Hands-on experience with HIS/HMS software and TPA portals (e.g., Medi Assist, MD India, Raksha, FHPL).

- Core Competencies: Strong analytical mind, sharp follow-up and negotiation skills, and excellent team management abilities.

What We Offer

Competitive salary aligned with industry standards.

Opportunities for professional growth and leadership.

A supportive and safety-first working environment.

Pay: ₹360,000.00 - ₹420,000.00 per year

Work Location: In person