TPA Executive Job Vacancies in Navi Mumbai

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

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

Determines patient invoice by capturing services noted in patient chart; clarifying services with physicians.Identifies responsible party by examining patient record.Issues invoice by entering service data; calculating charges; mailing invoices.Resolves billing issues by discussing contract with third-party payer; explaining insurance contract with patient; negotiating settlement.Maintains patient and invoice files by entering and adjusting data.Provides billing information by collecting, analyzing, and summarizing third-party billings, accounts pending.Ensure that patients claims are processed based on the services, and submitted to the authorities in due time.