TPA Executive

Drlogy; Jaipur; On-site; INR 300,000 - 450,000; Full time

Job summary

Drlogy in Jaipur is seeking an experienced TPA Executive to manage insurance approvals, coordinate cashless hospitalization processes, and ensure patient support services. This role involves verifying insurance eligibility, processing claims, and maintaining compliance with insurance guidelines.

The ideal candidate will effectively collaborate with TPAs and internal departments while maintaining confidentiality and participating in compliance audits.

Responsibilities

• Manage insurance approvals and cashless hospitalization processes.
• Verify patient insurance eligibility and coverage.
• Process pre-authorization and claim documentation.
• Coordinate with TPAs and insurance providers.
• Maintain insurance records and claim files.
• Monitor pending claims and approvals.
• Ensure compliance with insurance guidelines.
• Coordinate with billing and clinical departments.
• Generate insurance reports and summaries.
• Maintain confidentiality of patient information.
• Participate in audits and compliance reviews.
• Ensure timely document submission.
• Contribute to efficient insurance operations.

Job description

Experienced TPA Executive responsible for managing insurance approvals, cashless hospitalization processes, claim documentation, and patient insurance support services.

• Coordinate insurance approval processes efficiently.
• Verify patient insurance eligibility and coverage.
• Process pre-authorization and claim documentation.
• Coordinate with TPAs and insurance providers.
• Maintain insurance records and claim files.
• Monitor pending claims and approvals.
• Ensure compliance with insurance guidelines.
• Coordinate with billing and clinical departments.
• Generate insurance reports and summaries.
• Maintain confidentiality of patient information.
• Participate in audits and compliance reviews.
• Ensure timely document submission.
• Contribute to efficient insurance operations.