TPA Executive Graduate Jobs in Mumbai

Position: TPA/Health Insurance ExecutiveJob Location: Delhi, Mumbai, Kolakata, Hyderabad, Pune & ChennaiQualification : Any Medical graduation (BAMS / BUMS / BHMS / BDS)Experience: least 1 years' experience in Health Insurance / TPA /Insurance Brokerage.Skills: Excellent people management skills Ability to use technology to improve outcomes Good Excellent oral and written communication, negotiation and decision-making skills. Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.Roles & Responsibilities: TPA/Empanelment. Manage & track cashless claims at hospital File upload and validation Maintain claims data and prepare reports Support patients with documentation assistance and clarify insurance queries. Prepare and maintain SOPs for claimsprocessing

Accounting & Management-Setup of process & automation-Management of master fees files-Management & control of Fees booking entries in accounting software Tally-Controlling billing/invoicing across county-Arrangements of TPA Service Charge Reports-Coordination with all outstation offices-Fees Collection Follow-up for early release of payment-Resolving queries from Ins. Co. towards Fees -Resolving system issues at Ins. Co.-Lower TPA Fees Rate Confirmations & Follow-ups with Ins. Co. & inter departments-Liasoning with officials of Ins. Co. for early settlement of Fees & other queries-Reconciliation of Pending Fees in books of accounts-Fees MIS Management required by Ins. Co.-Audit Compliance of Ins. Co. -Compliance of internal & statutory auditors within our company.Apart from above mentioned routine work responsibilities, performing additional responsibilities:-MIS Reports Development for department-Net Banking setup for transactionsPresentation & Training

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

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