TPA/ Billing Executive

Nexus Pain Management Center; Chennai District, Bengaluru; On-site; INR 250,000 - 420,000; Full time

Job summary

Nexus Pain Management is seeking a detail-oriented TPA / Billing Executive to manage patient billing, insurance/TPA coordination, pre-authorizations, claims, and payment follow-ups. The candidate will ensure accurate billing and smooth coordination between patients, doctors, insurance companies, and internal departments.

Join Nexus Pain Management to handle billing, TPA coordination, and related documentation with strong Excel skills and a focus on accuracy and confidentiality.

Qualifications

• Graduation or equivalent in Healthcare/Hospital Administration, Finance, or Accounts.
• Experience in Hospital Billing, TPA, Insurance, or Cashless Claims preferred.
• Strong communication and coordination skills.

Responsibilities

• Handle patient billing and ensure accurate preparation of bills and invoices.
• Coordinate with TPA and insurance companies for cashless approvals and claim processing.
• Prepare and submit documents for pre-authorization, enhancements, and final approvals.
• Follow up with insurance companies and TPAs for pending approvals and claims.
• Verify patient insurance eligibility, policy coverage, and required documentation.
• Coordinate with patients regarding insurance documents, co-payments, deductions, and non-covered expenses.
• Maintain records of approved, pending, rejected, and settled insurance claims.
• Handle billing corrections, cancellations, refunds, and payment reconciliation as per policy.
• Coordinate with Front Office, Doctors, Finance, and Operations teams for smooth discharge and billing.
• Prepare daily/monthly reports related to billing, collections, pending claims, and settlements.
• Maintain confidentiality of patient and financial information.
• Resolve patient queries related to bills, insurance approvals, and payments professionally.

Skills

Attention to detail

MS Excel

Communication & coordination

Billing systems

Education

Bachelor's degree or equivalent in Healthcare/Finance/Accounts

Tools

Billing software

Job description

Job Description TPA / Billing Executive

Company: Nexus Pain Management

Department: Accounts / Operations

Position: TPA / Billing Executive

Reports To: Center Manager / Operations Manager

Job Summary

Nexus Pain Management is looking for a detail-oriented and experienced TPA / Billing Executive to manage patient billing, insurance/TPA coordination, pre-authorizations, claims, and payment follow-ups. The candidate will ensure accurate billing and smooth coordination between patients, doctors, insurance companies, and internal departments.

Key Roles & Responsibilities

• Handle patient billing and ensure accurate preparation of bills and invoices.
• Coordinate with TPA and insurance companies for cashless approvals and claim processing.
• Prepare and submit documents for pre-authorization, enhancements, and final approvals.
• Follow up with insurance companies and TPAs for pending approvals and claims.
• Verify patient insurance eligibility, policy coverage, and required documentation.
• Coordinate with patients regarding insurance documents, co-payments, deductions, and non-covered expenses.
• Maintain proper records of approved, pending, rejected, and settled insurance claims.
• Handle billing corrections, cancellations, refunds, and payment reconciliation as per company policy.
• Coordinate with the Front Office, Doctors, Finance, and Operations teams for smooth patient discharge and billing.
• Ensure all billing and TPA documentation is completed accurately and within the required TAT.
• Prepare daily/monthly reports related to billing, collections, pending claims, and insurance settlements.
• Maintain confidentiality of patient and financial information.
• Resolve patient queries related to bills, insurance approvals, and payments professionally.

Candidate Requirements

• Any Graduate or relevant qualification in Healthcare/Hospital Administration, Finance, or Accounts.
• Experience in Hospital Billing, TPA, Insurance, or Cashless Claims is preferred.
• Knowledge of insurance and TPA processes, pre-authorizations, and claim documentation.
• Good communication and coordination skills.
• Basic knowledge of MS Excel and billing systems/software.
• Ability to work under pressure and handle multiple patient cases simultaneously.
• Attention to detail and strong follow-up skills.

Preferred Experience

1–3 years of experience in Hospital Billing / TPA / Insurance Claims.

Join Nexus Pain Management and be part of a growing healthcare organization focused on delivering quality patient care.