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Job Description
The TPA Executive will be responsible for handling insurance, cashless, pre-authorization, claim documentation, discharge approval, and claim follow-up activities in the hospital. This requires knowledge of TPA processes, insurance documentation, hospital billing coordination, patient communication, and portal handling. The candidate will ensure timely approvals, accurate claim documentation, smooth insured-patient support, and proper coordination with hospital teams.
Roles & Responsibilities
- Handle TPA, insurance, cashless, and reimbursement cases for hospital patients.
- Verify policy details, patient documents, eligibility, and required claim papers.
- Prepare and submit pre-authorization requests through TPA or insurance portals.
- Coordinate with patients, relatives, billing, doctors, nursing, admission, and discharge teams.
- Track approval status, queries, enhancements, discharge approval, and claim settlement.
- Maintain records of approved, pending, rejected, and closed insurance cases.
- Submit discharge summary, bills, investigation reports, and treatment documents on time.
- Respond to insurance company queries and coordinate required corrections.
- Guide patients regarding insurance process, required documents, shortfall, and approval status.
- Support billing team with package, estimate, final bill, and settlement coordination.
- Follow up for pending claims, delayed approvals, and insurance-related clarifications.
- Maintain confidentiality of patient and insurance-related information.
- Prepare daily TPA claim reports and pending case updates for seniors.
- Follow hospital SOPs, insurer guidelines, and documentation standards.
- Ensure smooth, accurate, and timely TPA support for patients and hospital operations.
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About Somani Multispecialty Hospital
Somani Multispecialty Hospital is a leading NABH-accredited healthcare institution committed to providing world-class medical care at an affordable cost. Established on 1st February 2007 by Dr. Rajkumari Somani and Dr. Naresh Somani, the hospital has emerged as one of Jaipur's trusted destinations for comprehensive and compassionate healthcare. With a strong commitment to clinical excellence and patient-centered care, the hospital has successfully served more than 25,000 patients over the past 15 years.
Located at Shri Gopal Nagar, Gopalpura Bypass, Jaipur, Rajasthan, Somani Multispecialty Hospital is a modern 50-bedded facility equipped with advanced medical technology and 24×7 emergency services. The hospital strives to provide quality treatment while ensuring affordability and accessibility for all sections of society.
Our Vision
To provide world-class healthcare services with compassion, excellence, and affordability while improving the health and well-being of the communities we serve.
Our Mission
To deliver ethical, evidence-based, and patient-focused healthcare through advanced technology, experienced specialists, and a commitment to excellence in medical services.
Leadership
Somani Hospital was founded by:
Dr. Rajkumari Somani
Senior Obstetrician and Gynecologist
Dr. Rajkumari Somani is an experienced gynecologist specializing in high-risk pregnancies and women's healthcare. She has played a pivotal in promoting clinical research and charitable healthcare initiatives.
Dr. Naresh Somani
Senior Medical Oncologist
Dr. Naresh Somani is Rajasthan's first DM-qualified Medical Oncologist and has extensive experience in oncology and clinical research. He has participated in more than 55 clinical trials and has significantly contributed to cancer awareness and treatment.
Centers of Excellence
Somani Multispecialty Hospital offers specialized treatment across various disciplines, including:
- Oncology
- Obstetrics & Gynecology
- General Medicine
- Urology
- General Surgery
- Critical Care Medicine
- Palliative Care
- Physiotherapy
- Dentistry
- Clinical Trials and Research
- Diagnostic Laboratory Services
Advanced Healthcare Infrastructure
The hospital is equipped with modern facilities and technology, including:
- 50-bed NABH-accredited healthcare facility
- 24×7 Emergency and Intensive Care Services
- Seven-bedded Intensive Care Unit (ICU)
- Two Modular Operation Theatres with C-Arm and Operating Microscope
- CT Scan, X-Ray, Sonography, Colour Doppler, ECHO, and Bronchoscopy Services
- Fully Equipped Laboratory
- Pharmacy with Home Delivery Services
- Ambulance Services
- High Dependency Unit (HDU)
- Isolation Ward and Specialized Day Care Ward
Commitment to Community Healthcare
Through its philanthropic initiative, "Jeevan Pradata," Somani Hospital provides free and subsidized medical treatment to economically disadvantaged patients. The hospital remains committed to serving humanity with compassion and supporting community welfare through charitable healthcare and educational initiatives.
Why Choose Somani Multispecialty Hospital?
- NABH Accredited Hospital
- More than 15 years of healthcare excellence
- 25,000+ patients treated
- Experienced team of specialists and healthcare professionals
- Advanced diagnostic and surgical facilities
- Comprehensive cancer care services
- 24×7 emergency and critical care support
- Affordable and compassionate healthcare
- Strong focus on research and clinical excellence
Our Commitment
At Somani Multispecialty Hospital, we believe that healthcare is more than treatment—it is about trust, compassion, and improving lives. Through innovation, expertise, and patient-centered care, we continue to uphold our commitment to delivering exceptional healthcare services and creating healthier communities for generations to come.
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