TPA Executive

Eye-Q Vision Pvt Ltd; Gurugram District; On-site; INR 300,000 - 420,000; Full time

Job summary

Eye-Q Eye Hospitals is seeking a TPA Executive to manage TPA processes and ensure smooth insurance claims handling. You will verify policy eligibility, coordinate with insurers, process claims, and maintain accurate records of all TPA transactions.

Join our team to ensure efficient insurance processing for patients while collaborating with hospital staff to deliver seamless TPA services.

Qualifications

• Excellent communication and interpersonal skills.
• Strong problem-solving and analytical abilities.
• Detail-oriented with strong organizational skills.

Responsibilities

• Handle patient queries on insurance claims and TPA matters.
• Verify policy eligibility before treatment.
• Coordinate with insurers for timely treatment approvals.
• Process TPA claims and follow up for settlement.

Skills

Strong communication

Problem-solving

Attention to detail

Organizational skills

Fast-paced work ability

Proficiency with computer applications

Tools

Insurance claim software

Hospital management systems

MS Office Suite

CRM systems

Job description

Company Name: Eye-Q Eye Hospitals

Job Title: TPA Executive

Job Description

As a TPA Executive at Eye-Q Eye Hospitals, you will be responsible for managing the Third Party Administrator (TPA) processes to facilitate efficient claims processing and patient management. Your role will involve working closely with insurance companies, patients, and healthcare providers to ensure smooth operations and adherence to company policies. You will assist in the verification of health insurance policies, process claims, and address any issues that may arise in the TPA operations.

Key Responsibilities

• Handle patient queries regarding insurance claims and TPA-related matters.
• Verify eligibility of health insurance policies for patients before treatment.
• Coordinate with insurance companies to ensure timely approval for treatments.
• Process TPA claims and follow up on pending claims to ensure timely settlement.
• Maintain accurate records of all TPA-related transactions and documentation.
• Collaborate with hospital staff to ensure a seamless experience for patients using TPA services.
• Assist in resolving any issues or discrepancies related to TPA claims.

Skills Required

• Strong communication and interpersonal skills.
• Excellent problem-solving abilities.
• Attention to detail and organizational skills.
• Ability to work in a fast-paced environment.
• Proficiency in using computer applications and databases.

Tools Required

• Knowledge of insurance claim processing software.
• Familiarity with hospital management systems.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
• Experience with customer relationship management (CRM) systems is a plus.

Join Eye-Q Eye Hospitals as a TPA Executive and contribute to providing quality healthcare services while ensuring efficient insurance processing for our patients.