TPA Executive

TPA Executive is responsible for managing insurance, mediclaim, claims processing, TPA coordination, documentation, approvals, and hospital administration support. The requires any graduate, hospital administration, or healthcare management qualification with 2 to 7 years of experience. Candidates should have strong knowledge of TPA, mediclaim, insurance claims, hospital administration, billing coordination, and healthcare management.

Role & Responsibilities

• Coordinate with TPA, insurance companies, and patients for claim processing.
• Verify insurance documents, policy details, approvals, and claim requirements.
• Prepare pre-authorization, enhancement, and final claim documentation.
• Coordinate with billing, admission, discharge, doctors, and nursing teams.
• Track pending approvals, queries, deductions, and claim status.
• Explain insurance and mediclaim processes to patients and attendants.
• Maintain TPA records, claim files, and documentation trackers.
• Support discharge billing and claim settlement coordination.
• Respond to insurance queries with accurate supporting documents.
• Follow hospital policies and insurance documentation standards.
• Maintain confidentiality of patient and financial information.
• Ensure smooth, timely, and patient-friendly insurance support.