TPA Executive

Criticare Asia Hospital is seeking a detail-oriented and proactive TPA Executive to manage insurance and third-party administrator (TPA) processes, ensure timely approvals, and facilitate smooth patient billing and claim settlements. The involves coordination with insurance companies, patients, and internal departments to ensure efficient cashless and reimbursement processes.

Roles & Responsibilities

• Handle end-to-end TPA and insurance processes for cashless and reimbursement cases.
• Coordinate with insurance companies and TPAs for pre-authorization and approvals.
• Verify patient insurance details, policy coverage, and eligibility criteria.
• Prepare and submit accurate documentation for cashless approvals and claims.
• Follow up with TPAs/insurers for timely approval, query resolution, and claim settlement.
• Ensure proper documentation of all insurance-related cases as per hospital policies.
• Coordinate with billing, front office, and clinical teams for smooth patient processing.
• Manage patient admission and discharge processes related to TPA cases.
• Handle queries and grievances related to insurance and billing with professionalism.
• Ensure timely closure of TPA files and claim documentation.
• Track pending claims, approvals, and payments, ensuring minimal delays.
• Monitor rejected or query cases and take corrective actions for resolution.
• Maintain accurate records of all TPA transactions and communications.
• Ensure compliance with insurance guidelines, hospital policies, and regulatory requirements.
• Assist patients and relatives in understanding insurance processes and documentation.
• Support audits by providing necessary insurance and billing documents.
• Prepare MIS reports related to TPA cases, approvals, and claim status.
• Maintain confidentiality of patient and financial information.
• Coordinate for corporate tie-ups and empanelment processes if required.
• Continuously improve processes to enhance efficiency and patient satisfaction.

CritiCare Asia Multispeciality Hospital is a modern healthcare institution dedicated to providing comprehensive and high-quality medical services. The hospital focuses on delivering patient-centric care through advanced technology and a team of experienced healthcare professionals.

Our Story

CritiCare Asia Multispeciality Hospital was established with the vision of offering accessible and reliable healthcare services under one roof. Over time, it has built a reputation for clinical excellence, compassionate care, and commitment to patient well-being.

Our Mission

• To provide high-quality and affordable healthcare services
• To ensure patient safety and clinical excellence
• To deliver compassionate and ethical care
• To continuously adopt advanced medical technologies

Our Vision

To be a leading multispeciality hospital recognized for excellence in healthcare services and patient satisfaction.

Our Services / What We Offer

CritiCare Asia Multispeciality Hospital offers a wide range of healthcare services:

• Multi-speciality consultations and treatments
• Advanced diagnostic and imaging services
• Surgical and critical care services
• Emergency and trauma care
• Preventive healthcare and wellness programs

Why Choose Us

• Comprehensive multispeciality care under one roof
• Experienced team of doctors and healthcare professionals
• Advanced infrastructure and modern medical technology
• Patient-centric approach with focus on safety and comfort
• Commitment to quality healthcare services

Our Team

The hospital is supported by a team of skilled doctors, surgeons, nurses, and healthcare staff dedicated to delivering effective and compassionate care.

Infrastructure / Technology

CritiCare Asia Multispeciality Hospital is equipped with state-of-the-art infrastructure and advanced medical equipment to ensure accurate diagnosis and effective treatment.

Our Commitment

CritiCare Asia Multispeciality Hospital is committed to improving healthcare outcomes by delivering safe, reliable, and high-quality medical services. The hospital emphasizes innovation, ethical practices, and patient satisfaction.