Tpa Executive / Tpa Manager

Medico Hub; Cuttack; On-site; INR 1,200,000 - 2,000,000; Full time

Job summary

Medico Hub in Cuttack, Odisha invites an experienced TPA Executive/Manager to oversee hospital TPA and insurance operations. The role requires managing cashless admissions, pre-authorisations, claims, and coordination with insurers, doctors, and hospital administration.

The candidate should have a minimum of 5 years in hospital TPA/insurance operations, strong documentation and communication skills, and the ability to independently drive TPA activities across schemes.

Qualifications

• Graduate or postgraduate in hospital administration or healthcare management.
• Minimum 5 years hospital TPA/insurance operations experience.
• Strong knowledge of TPA, cashless insurance, and hospital billing procedures.
• Excellent communication and coordination skills.
• Ability to independently manage TPA operations.

Responsibilities

• Manage day-to-day TPA and medical insurance operations.
• Handle cashless patient admissions and discharge processes.
• Manage pre-authorisation, approvals, claim submissions, and settlements.
• Coordinate with insurance companies and TPAs.
• Handle claim queries, rejections, and pending payments.
• Ensure proper medical documentation and billing coordination.
• Coordinate with doctors, billing, accounts, and hospital administration teams.
• Ensure timely claim processing and compliance with insurance guidelines.

Skills

Communication

Coordination

Documentation

Problem-solving

TPA operations

Education

Graduate/PG in Hospital Administration

Job description

Location

Cuttack, Odisha

Position

TPA Executive / TPA Manager

Industry

Hospital / Healthcare

Experience

Minimum 5 Years of Previous Hospital Experience

Qualification

• Graduate/Postgraduate in Hospital Administration, Healthcare Management, or a relevant field.
• Minimum 5 years of experience in hospital TPA and insurance operations preferred.

Key Responsibilities

• Manage day-to-day TPA and medical insurance operations.
• Handle cashless patient admissions and discharge processes.
• Manage pre-authorisation, approvals, claim submissions, and settlements.
• Coordinate with insurance companies and Third-Party Administrators.
• Handle claim queries, rejections, and pending payments.
• Ensure proper medical documentation and billing coordination.
• Manage ECHS, ESIC, Ayushman Bharat, and other government healthcare schemes, wherever applicable.
• Coordinate with doctors, billing, accounts, and hospital administration teams.
• Ensure timely claim processing and compliance with insurance guidelines.

Candidate Requirements

• Minimum 5 years of previous hospital experience.
• Strong knowledge of TPA, cashless insurance, and hospital billing procedures.
• Good communication and coordination skills.
• Strong documentation and problem-solving abilities.
• Ability to independently manage TPA operations.

Salary: Negotiable, based on qualifications and experience.