Job Summary:
We are looking for a dedicated and detail-oriented TPA (Third Party Administrator) Coordinator to manage all insurance-related tasks, including pre-authorizations, patient documentation, claim processing, and follow-up with TPA/insurance companies.
Key Responsibilities:
- Coordinate with patients and their families regarding insurance policies and documentation.
- Submit pre-authorization requests to TPAs and insurance providers in a timely manner.
- Follow up on approvals, queries, and rejections from TPAs.
- Handle discharge intimation, final authorization, and e-mail communications.
- Maintain proper records of insurance claims, patient files, and authorization letters.
- Work closely with the billing department for claim settlement and approvals.
- Ensure timely submission of final bills and discharge summaries.
- Handle claim queries and support audits or documentation verifications.
- Keep updated with TPA guidelines and policy changes.
- Coordinate with consultants and hospital departments for necessary medical information.
Skills Required:
- Good communication (English, Hindi, and regional language)
- Familiarity with medical terminologies and hospital systems
- Basic computer skills (MS Office, Hospital Management Software)
- Ability to multitask and handle pressure
- Strong organizational and documentation skills
Preferred Candidates:
- Experience in a hospital/clinic setting with exposure to TPA operations.
- Understanding of IRDAI regulations and healthcare insurance processes.
Job Type: Full-time
Pay: ₹25,000.00 - ₹30,000.00 per month
Work Location: In person
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