TPA Coordinator Jobs

Talking preauth Ipd billing Reiumbusment claim procedure Communication with claim company about queries

We have vacant of 1 TPA Coordinator Job in Kalyan, Thane, Experience Required : 2 Years Educational Qualification : B.A, B.B.A, B.Com, B.Sc Skill Insurance, Patient Care, Good Communication Skills, Medical Billing etc. Act as a liaison between hospital, patients, and TPAs/insurance companies. Handle pre-authorization, approvals, and claim submissions for cashless treatment. Maintain proper documentation of insurance claims, bills, and approvals. Verify patient insurance details and eligibility before admission. Coordinate with billing, accounts, and treating doctors for claim-related requirements. Ensure timely submission of bills and settlement of insurance claims. Track pending claims and follow up with TPAs/insurance providers. Maintain MIS reports on insurance patients and claim status. Assist patients/families in understanding insurance coverage and exclusions.

MAKING REIMBURSSMENT, MAKING IPD BILLING, MAKING CASHLESS PROCEDURE,PREAUTH TAKING, EMPANELMENT

Should have idea about Hospital Management

We have vacant of 2 TPA Coordinator Jobs in Vashi, Navi Mumbai, Experience Required : 2 Years Educational Qualification : Higher Secondary Skill TPA Coordinator etc.

should be able to handle the tpa desk effectively

Pre authorization requestsFinal ApprovalsSPOC between TPA & PatientsUndertakings & ConsentsTPA Recovery & RecordCoordination with Centre Incharge, Billing, Counselor, & OT.

Should have Strong Knowledge in Aarogysri Documentation, Preauth and Claims.mou Renewalclaim Managementco Ordination with Government Authoritiesars End to End Procedure

Responsibilities:1. Oversee and manage relationships with Third-Party Administrators in the hospital sector.2. Ensure efficient processing of medical claims, adhering to industry standards and regulations.3. Collaborate with cross-functional teams to streamline TPA-related processes for optimal efficiency.4. Implement and enforce best practices in TPA management to enhance operational excellence.5. Provide strategic guidance on TPA negotiations and contract management.6. Stay abreast of industry trends and regulations impacting TPA operations.7. Foster strong partnerships with TPA providers to optimize service delivery and customer satisfaction.Requirements: Proven experience in TPA management within the hospital industry. In-depth knowledge of healthcare regulations and compliance standards. Strong negotiation and contract management skills. Excellent communication and interpersonal abilities. Demonstrated ability to optimize operational processes for TPA efficiency. Relevant educational background in healthcare management or a related field.Note: Only candidates with a background in the hospital industry should apply.

Full job descriptionWe are looking for a TPA for Our Client company based in Australia in Gurgaon.(What Is a Third-Party Administrator (TPA)?A third-party administrator is a company that provides operational services such as claims processing and employee benefits management under contract to another company. Insurance companies and self-insured companies often outsource their claims processing to third parties.)Roles & ResponsibilitiesHandling TPA-related all processes from billing to coordinating with TPA companies.Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Interpret the ICD coding, evaluate co-pay details, and classify non-medical expenses, room tariff, and capping...Assisting with all co-ordination activities from patient's admission to discharge.Follow up with Insurance companies to pass or clear the Health Insurance claims.REQUIREMENTSShould have good knowledge of all TPA work.Must be aware of the norms of the insurance sector.Basic Knowledge of billing.Required Exp from TPA , health insurance background, knows cost containment.International Classification of Diseases (ICD) Education Qualification: Doctor Degree Only in medical Job Type: Full-timeSalary: 35,000.00 - 70,000.00 per monthSchedule: Day shiftAbility to commute/relocate:Near Mg Metro Station, Gurgaon - 122001, HaryanaReliably commute or planning to relocate before starting work (Preferred)Experience:TPA: 4 year (Preferred)Note: Only immediate joiners can apply

1. Handling Cashless / Health insurance patients at hospital. 2. Generating their bills, submitting it to insurance company / TPA's, taking follow ups for approvals and payments.3. Sending their files to concern company, 4. Keeping record of all cashless patients till getting its payment.5. Handling company portals essentially.6. Keeping watch on company tie-ups with hospital, trying to attach insurance companies / TPA'S with hospital and maintaining good relations with existing companies. 7. Supporting to hospital for other works

We have vacancy of 1 TPA Coordinator Job in Varanasi, Uttar Pradesh having good communication skills, knowledge of ms office, ms excel, editing and dealing with various insurance companies for cashless hospitalization and experience in PMJAY procedures, Experience Required : min 2 Years Educational Qualification : Advanced/Higher Diploma, Professional Degree, Other Bachelor Degree, B.Com, B.Sc, M.Com, M.Sc

Responsibilities:Develop and implement business development plans and strategies to attract and retain businesses in the region.Responsible for sustaining and growing the revenues with lead generation responsibilities.Laying down the roadmap for new account acquisition for the city and ensuring its execution.Strategizing and executing in coordination with other teams to develop new and better methods to drive client engagement.Candidates should have relevant experience in Business development and have a positive approach towards targets.Should be enthusiastic and smart to create a good impression in front of clients.Skills Required:Graduate/Post Graduate with 2-5 Years year work experience.Candidate must have experience in dealing with customers over phone and in personStart-up and Insurance exposure is preferred.Strong time management skills and the ability to prioritize to meet daily, weekly, and long-term requirements and goals.Structured problem solving and customer first attitude.Desire to network and align with the vision and mission of the organization

Responsible to check the OPD bill of TPA/PSU/Corporate as per their agreed MOU for particular on daily basis.Responsible to check the TPA & PUS (CGHS) OPD (health Insurance) bill as per approved terms & condition by particular TPA.Responsible for final checking (OPD bills) of TPA/Corporate before dispatch for make the payment at particular TPA or Corporate/PSU.Responsible to communicate ant kind of billing error or any kind of document related dispute to OPD Billing team.Responsible for final checking (OPD Bills) of TPA/Corporate/PSU before dispatch for make the payment at particular TPA or corporateCoordinating with IT department regarding any software error on the billing or for any new implementation.Responsible for update the status of dispatch for E-Prapti.Responsible to maintaining a TAT.Responsible to Query reply TPA/Corporate/PSU

Complete Preauthorization ProcessTPA Discharge processTPA BillingTDS & discount calculationsClaim Settlements TPA Outstanding Recovery

To confirm the claim is received in correct MAID, Hospital, etc,To capture the bifurcation of Admissible and Non-admissible paymentsTimings : 8 hrs /6 daysRequired Candidate profileQualification : BSC / MSC Nursing,Fresher & experience both are welcomed!!

Managing the insurance desk in hospitals, Preauth processing, patient coordination, Claim adjudication .Follow up with insurance and TPAs .Healthcare management domain.

HANDLE CASHLESS AND REIMBURSEMENT CLAIM PROCESSINGCOORDINATE WITH INSURANCE COMPANIES TPA FOR APPROVAL AND QUERRIESVERIFY PATIENTINSURANCE ELIGIBILITY AND DOCUMENTSSUBMIT AND TRACK PREAUTHORISATION REQUEST PREPARED DAILY MONTHLY REPORT OF CLAIM

Job Description:To confirm the claim is received in correct MAID, Hospital, etc,To capture the bifurcation of Admissible and Non-admissible paymentsTimings : 8 hrs /6 days

1. Candidates should be flexible with rotational shifts, rotational week off, working on 1 Sunday and Public holiday. Candidate is eligible for 6days week off monthly.2. Please find the shift detail-1. Morning shift- 8am to 4.30pm2. General Shift- 10 am to 6.30pm

Dear Doctors,we have openings for TPA insuranceLocation ; MumbaiWorking hours:8hrsSalary : negotiable