TPA Executive

The TPA Executive will be responsible for managing insurance, cashless, corporate, pre-authorization, claim documentation, discharge approval, and TPA coordination at Health1 Hospital, Ahmedabad. This requires any graduate qualification, 1–2 years of experience, knowledge of hospital insurance processes, documentation accuracy, communication skills, and coordination with billing, doctors, MRD, patients, and insurance providers.

Roles & Responsibilities

• Manage TPA, insurance, corporate, and cashless patient coordination.
• Verify insurance policy details, patient documents, proof, and eligibility requirements.
• Prepare and submit pre-authorization forms, medical documents, and claim papers.
• Coordinate with doctors, billing, MRD, nursing, patients, and insurance companies.
• Track approvals, enhancements, queries, denials, final approvals, and discharge clearance.
• Explain insurance process, documents, approvals, and patient responsibility clearly to attendants.
• Maintain TPA files, claim records, approval letters, query responses, and daily trackers.
• Support discharge billing by coordinating final authorization and insurance clearance.
• Follow up with TPA companies for pending approvals and claim status updates.
• Ensure accuracy in diagnosis details, treatment notes, package information, and billing documents.
• Escalate rejected, delayed, or disputed claims to seniors promptly.
• Maintain confidentiality of patient, insurance, and financial information.
• Prepare MIS reports related to cashless cases, pending claims, and approvals.
• Follow hospital TPA SOPs, documentation standards, and compliance requirements.
• Ensure smooth, timely, and patient-friendly insurance service support.

Health1 Super Speciality Hospitals is a modern group of healthcare facilities that started its journey in 2017 with a mission to create a healthier society and deliver the best patient‑centric care. The hospital group focuses on over 40+ super‑speciality branches, offering advanced infrastructure, cutting‑edge technology, and ultra‑modern medical facilities along with patient comfort and compassionate care.

At the Shilaj branch (West Ahmedabad), the hospital is a 151+ bedded ultra‑modern super‑speciality facility featuring multiple state‑of‑the‑art operation theatres, Cath Labs, a large ICU, 24×7 emergency services, dedicated dialysis, radiology, pathology, physiotherapy centres, and more , all under one roof to provide comprehensive healthcare services.

Health1 believes in a multidisciplinary and holistic approach to medical care, tailoring treatments to individual needs and ensuring smooth patient experiences to support faster recovery. Their philosophy emphasises ethical, quality healthcare at affordable pricing, combining advanced technologies with expert doctors to form “the hospital that cares.”