Tpa Coordinator

Cancer Centers of America; Amritsar; On-site; INR 600,000 - 900,000; Full time

Job summary

Cancer Centers of America in Amritsar, India, is seeking a Billing/Claims Executive to coordinate with doctors, nursing staff, and insurance representatives for timely approvals and submissions. You will verify records, ICD coding, and reports before submission, and follow up on authorizations and payments.

You will maintain MIS reports and claim trackers, aiming for higher approval rates with fewer rejections, while ensuring confidentiality and compliance with hospital policies.

Responsibilities

• Coordinate with treating doctors, nursing staff, billing department, and insurance representatives for timely approvals and claim submissions.
• Verify medical records, treatment protocols, ICD coding, investigation reports, and discharge summaries before claim submission.
• Follow up on pending authorizations, deficiencies, rejected claims, and payments.
• Maintain daily MIS reports, claim status trackers, pending approvals, and revenue reports.
• Ensure maximum approval rates with minimum claim rejections.
• Coordinate with TPAs, insurance companies, PM-JAY authorities, and government agencies regarding claim-related matters.
• Train and guide internal staff regarding documentation requirements and panel compliance.
• Ensure confidentiality of patient records and comply with hospital policies.

Job description

• Coordinate with treating doctors, nursing staff, billing department, and insurance representatives for timely approvals and claim submissions.
• Verify medical records, treatment protocols, ICD coding, investigation reports, and discharge summaries before claim submission.
• Follow up on pending authorizations, deficiencies, rejected claims, and payments.
• Maintain daily MIS reports, claim status trackers, pending approvals, and revenue reports.
• Ensure maximum approval rates with minimum claim rejections.
• Coordinate with TPAs, insurance companies, PM-JAY authorities, and government agencies regarding claim-related matters.
• Train and guide internal staff regarding documentation requirements and panel compliance.
• Ensure confidentiality of patient records and comply with hospital policies.