TPA Executive Jobs

A TPA (Third Party Administrator) Executive in a hospital manages the insurance and cashless claim processes between patients, the hospital, and insurance companies.Key ResponsibilitiesPre-Authorization: Submit initial treatment estimates and medical notes to insurance portals for cashless admission approvals.Claim Processing: Coordinate with hospital billing and clinical teams to compile final discharge bills and claim documents.Patient Guidance: Help patients understand their insurance coverage, policy limits, and out-of-pocket expenses.Liaison & Follow-Up: Talk to insurance company representatives to resolve queries, track pending approvals, and clear claim discrepancies.Record Keeping: Maintain logs of all processed, approved, rejected, and reimbursed claims

As a TPA Executive, you will play a crucial role in the processing and management of insurance claims. Your responsibilities and expectations are outlined below:Key Responsibilities:- Claim Processing: Review and process insurance claims efficiently to ensure timely approvals and settlements.- Communication: Act as a liaison between clients, insurance companies, and healthcare providers, ensuring clear and accurate communication regarding claims status and requirements.- Documentation Management: Maintain organized records of all transactions, documents, and correspondence related to insurance claims for easy retrieval and audit purposes.- Problem Resolution: Address and resolve any issues or discrepancies in claims processing, including addressing client inquiries and providing solutions.- Compliance Monitoring: Ensure that all claims adhere to company policies and regulatory requirements to minimize risks and maintain compliance.- Team Collaboration: Work closely with other team members and departments to streamline processes and improve overall efficiency in claims management.Required Skills and Expectations:Candidates should have a bachelor's degree in Commerce or a relevant vocational course. A professional degree or higher diploma is preferred. You should have a minimum of 4-10 years of experience in insurance claim processing or a related field. Strong analytical skills, attention to detail, and effective communication abilities are essential. Familiarity with insurance regulations, claim management software, and a proactive approach to problem-solving are highly valued. The role requires you to be a team player, capable of working in a fast-paced office environment while managing multiple tasks effectively.

As a TPA Executive, you will play a crucial role in facilitating the smooth and efficient management of insurance claims. You will work closely with clients, healthcare providers, and insurance companies to ensure that all transactions and communications are handled effectively.Key Responsibilities:- Claim Processing: Review and process claim documents, ensuring all necessary paperwork is complete and compliant with insurance protocols.- Client Coordination: Communicate with clients to gather required information and updates regarding their claims, addressing any questions or concerns they may have.- Provider Liaison: Work with healthcare providers to verify patient eligibility and benefits, ensuring that services rendered are aligned with the insurance coverage.- Documentation Management: Maintain detailed records of claims processed, communications, and resolutions to ensure transparency and compliance with company standards.- Problem Resolution: Address and resolve any issues or discrepancies that arise during the claims process, collaborating with relevant parties to achieve satisfactory outcomes.Required Skills and Expectations:Candidates should have at least 2 to 4 years of experience in a similar role, demonstrating a strong understanding of the insurance claims process. A minimum education level of 12th pass is required. Excellent communication skills are essential for effective interaction with clients and providers. Proficiency in Microsoft Office, particularly Excel, is expected for managing documentation and data. Candidates should be detail-oriented, capable of handling multiple tasks efficiently, and possess strong problem-solving abilities to navigate challenges in the claims process. A professional attitude and the ability to work in a team are also important for success in this role.

Work on filling TPA application for cashless treatment . Need to coordinate with insurance company to fill the form and guide patient.Need to be in hospital in working hrs .Should be aware of the necessary mandatory documents which is required be insurance companies

Hiring: TPA Billing Executive Hospital Location: Panvel, Navi Mumbai Salary: 15,000 22,000 (based on experience) Gender: Male / Female Experience: Minimum 1 year Industry: Hospital / HealthcareJob Responsibilities:Handling TPA & Insurance billingSubmission of cashless & reimbursement claimsCoordination with insurance companies & TPAsMaintaining patient billing and claim recordsFollow-up on approvals and paymentsRequirements:Minimum 1 year experience in hospital TPA billingKnowledge of insurance portals & claim processingGood communication and documentation skills Interested candidates can call: 9011935513

TPA Executive Required Urgently in Palwal So Pl Call or Send Your Updated Resume Thanks

Manage empanelment of hospitals with TPAs, insurance companies, corporates, and government schemes. Coordinate and ensure timely submission, follow-up, and closure of empanelment applications. Act as a single point of contact between client hospitals and external stakeholders (TPAs, insurers, regulators). Build and maintain strong client relationships, ensuring high satisfaction and retention. Track and update empanelment status, renewals, and compliance timelines. Support hospitals in meeting accreditation-related requirements for empanelment. Resolve client queries, escalations, and operational issues related to empanelment and accreditation. Maintain accurate documentation, MIS, and reporting for management review. Coordinate with internal quality, accreditation, and operations teams for smooth service delivery.Ensure compliance with regulatory, contractual, and confidentiality requirements.

Job title: Hospital TPA Desk executive (Fresher)Job Location : JokaGender Preference: Male Stipend: 5k/ Monthly (For 3 months) After that salary will be increase as per candidates performance.Qualification: Hospital Management Pursuing / Pass out.(12.00pm 5.00pm)

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

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

ResponsibilitiesClaims Management:Coordinate with TPAs for pre-authorization, cashless treatment approvals, and claims processing.Verify documents and ensure accurate and timely submission of claims.Track claim statuses and follow up on pending or rejected claims.Patient Coordination:Guide patients on eligibility and processes for PMJAY and TPA-related services.Ensure beneficiaries under PMJAY receive entitled treatment and services.Address grievances related to insurance and scheme benefits.Data Management:Maintain accurate records of TPA claims and PMJAY patient data.Regularly update databases with approvals, discharges, and claims status.Liaison Work:Act as a bridge between the hospital, insurance companies, and government authorities.Communicate with TPAs for policy updates and process changes.Collaborate with the PMJAY nodal agency for compliance and reporting.Compliance and Reporting:Ensure adherence to government and TPA guidelines.Prepare and submit periodic reports on claims, reimbursements, and patient benefits.Ensure alignment with PMJAY and IRDAI (Insurance Regulatory and Development Authority of India) standards.Awareness and Training:Educate hospital staff and patients on TPA and PMJAY policies and benefits.Conduct workshops or sessions to improve understanding of processes among stakeholders.Skills and CompetenciesStrong understanding of health insurance policies, PMJAY guidelines, and claim processing.Excellent communication and negotiation skills.Proficiency in data management and healthcare software.Problem-solving and grievance-handling abilities.Knowledge of regulatory and compliance requirements.QualificationsBachelor's degree in any field (preferably in healthcare, business administration, or insurance).Knowledge or experience in health insurance, TPA, or government health schemes like PMJAY.Familiarity with hospital operations is a plus.Work EnvironmentWorking closely with hospital administrator

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

We have vacant of 2 TPA Executive Jobs in Gurgaon,TPA Executive,Medical Officer,Health Insurance Counselor,Documentation Assistant, Experience Required : 1 Year Educational Qualification : Diploma, Professional Degree, B.Pharma, MBBS, M.Pharma, Other Doctorate Degree, Ph.D/Doctorate, DM/Doctorate of Medicine Skill TPA Executive,Medical Officer,Health Insurance Counselor,Documentation Assistant etc.Job location - Near MG Road Metro station, Gurgaon

We have vacant of 4 TPA Executive Jobs in Pimple Gurav, Experience Required : 2 Years Educational Qualification : Professional Degree,Other Bachelor Degree,B.A,B.Com Skill TPA , Billing Executive etc.

TPA Executive Required For Famous hospital in Tamil NaduLocation-1. Marthandam , Tamil NaduOther Details:-Salary - 12 - 15 kpm + IncentiveExperience : Fresher / Experienced AnyThe Interview Will Be Conducted Telephonic / VideoJob Role - Maintaining & uploading patient's files on the portal.Couriering the hard copy of patient's medical file to the Insurance companies. Good knowledge of TPA billing (Private / Corporate / Govt.) with ECHS, CGHS, Cashless RecoveriesHandle the team of Billing /Cashless TPA Executives with Following up with all the Insurance payer for payment or denials.Kindly Share In Your WhatsApp/ Facebook/Linkedin Etc Groups For HelpIf You Have Any Requirement For The Doctors Or Nurse For Your Hospital Or Center, Kindly Contact The Same Number.If You Don't Want To Receive Messages By Us, Kindly Reply No, We Will Never Message You AgainThanks & RegardsNamrataSenior RecruiterSpace Consultant

We are hiring for hospital TPA executive who have experience in government pannel billing and private pannel billing.

Send invoices and account updates to clientsKeep an accurate record of client accounts and outstanding balancesReceive, sort, and track incoming paymentsValidate debit accounts to ensure the credibility of paymentsIssue receipts for received paymentsAddress and solve client questions and issuesSecurely handle client data and payment informationProvide regular, accurate reports of billing data

Urgent Hiring for TPA Billing Executive at Chakan Pune Male Female both can apply min 1 to 2 yrs experience in Hospital Mediclaim , insurance claim , TPA Billing call for more 9011935513

Urgently Lookin for TPA Coordinator in Chikodi Belgaum KarnatakaMale female both can applyMin 1 yrs experience Hospital Experience is must Immediately Joining

Urgent required TPA Billing Executive in Wagholi Pune Male Female both can Apply Good experience requiredSalary AS per experience call 9011935513

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

We have urgent requirement for BAMS BHMS BUMS Doctors Hyderabad in Reputed OrganizationExp : Freshers or ExperiencedSalary : 4.4 Lpa Qualification : BAMS BHMS BUMSGender : AnyTimings : 10AM : 7.30PM & 11AM : 8.30 PMLocation: Banjara hillsHyderabad)NOTE: immediate joiners can applyKindly Refer to your friends and share in your groups