Senior Executive - TPA

Drlogy; Ahmedabad District; On-site; INR 400,000 - 600,000; Full time

Job summary

Drlogy in Ahmedabad District, Gujarat, is looking for a Senior Executive – TPA to manage insurance coordination and claims processing. The successful candidate will coordinate with Third Party Administrators (TPA), process both cashless and reimbursement claims, verify insurance documents, handle patient queries, and maintain accurate claim records. The role requires ensuring compliance with insurance procedures and efficiently resolving claim-related discrepancies. Join Drlogy to contribute to improving healthcare services through effective insurance management.

Responsibilities

• Coordinate with TPA and insurance companies.
• Process cashless and reimbursement claims.
• Verify insurance documents and approvals.
• Handle patient insurance queries and support.
• Maintain claim records and documentation.
• Follow up on pending approvals and settlements.
• Ensure compliance with insurance procedures.
• Coordinate with billing and clinical departments.
• Resolve claim-related discrepancies efficiently.
• Prepare TPA reports and operational updates.

Job description

The Senior Executive – TPA manages insurance coordination, claim processing, and communication with Third Party Administrators for smooth cashless and reimbursement services.

Key Responsibilities

• Coordinate with TPA and insurance companies
• Process cashless and reimbursement claims
• Verify insurance documents and approvals
• Handle patient insurance queries and support
• Maintain claim records and documentation
• Follow up on pending approvals and settlements
• Ensure compliance with insurance procedures
• Coordinate with billing and clinical departments
• Resolve claim-related discrepancies efficiently
• Prepare TPA reports and operational updates