Tpa Executive

Rama Hospital Noida-61; Dadri; On-site; INR 240,000 - 360,000; Full time

Job summary

Rama Hospital Noida-61 in Uttar Pradesh is seeking a TPA Executive to manage cashless admissions, insurance verification, and pre-authorization processes.

You will coordinate with TPAs and insurance portals, verify documents, and ensure timely submission of claims and final bills, while maintaining MIS reports.

Responsibilities

• Handle cashless patient admissions and insurance verification.
• Process pre-authorization requests through TPA and insurance portals.
• Coordinate with insurance companies for initial, enhancement and final approvals.
• Verify insurance documents, medical records and patient eligibility.
• Coordinate with IPD, Billing, MRD, Nursing and Doctors for required documentation.
• Handle discharge authorization and final bill submission.
• Prepare and submit insurance claim files within defined timelines.
• Follow up on pending claims, queries, deductions and rejected cases.
• Resolve insurance-related queries and discrepancies.
• Maintain daily MIS reports for cashless patients, approvals and pending claims.
• Monitor TPA-wise outstanding claims and ensure timely follow-ups.
• Ensure accurate documentation and minimize claim rejections.

Job description

Roles & Responsibilities TPA Executive

• Handle cashless patient admissions and insurance verification.


• Process pre-authorization requests through TPA and insurance portals.


• Coordinate with insurance companies for initial, enhancement and final approvals.


• Verify insurance documents, medical records and patient eligibility.


• Coordinate with IPD, Billing, MRD, Nursing and Doctors for required documentation.


• Handle discharge authorization and final bill submission.


• Prepare and submit insurance claim files within defined timelines.


• Follow up on pending claims, queries, deductions and rejected cases.


• Resolve insurance-related queries and discrepancies.


• Maintain daily MIS reports for cashless patients, approvals and pending claims.


• Monitor TPA-wise outstanding claims and ensure timely follow-ups.


• Ensure accurate documentation and minimize claim rejections.