Third Party Administrator

Job Summary:

Satkartar Sanjeevan Hospital is looking for an experienced Third Party Administrator (TPA Executive) to manage insurance and TPA operations efficiently. The ideal candidate should have hands-on experience in handling cashless approvals, insurance claims, reimbursement processes, and coordinating with insurance companies, TPAs, patients, and internal hospital departments.

Key Responsibilities

• Handle end-to-end TPA and insurance claim processes.
• Coordinate with insurance companies and TPAs for cashless approvals and claim settlements.
• Process pre-authorizations, reimbursements, and final claim submissions.
• Verify patient insurance eligibility and policy coverage.
• Ensure timely submission of all claim-related documents.
• Follow up with TPAs and insurance providers to resolve pending claims and queries.
• Coordinate with doctors, billing, admissions, and patients regarding insurance documentation.
• Maintain accurate records of approvals, rejections, and pending claims.
• Ensure compliance with hospital policies and insurance guidelines.
• Prepare daily, weekly, and monthly MIS reports related to TPA and insurance operations.

Required Skills

• Strong knowledge of TPA operations and health insurance processes.
• Experience in cashless hospitalization and reimbursement claims.
• Good understanding of hospital billing and medical documentation.
• Excellent communication and coordination skills.
• Strong analytical and problem-solving abilities.
• Proficiency in MS Excel, MS Word, and Hospital Information Systems (HIS).

Preferred Qualifications

• Bachelor's degree in any discipline.
• 2–5 years of experience in TPA/Insurance Operations within a hospital.
• Familiarity with major TPAs and health insurance companies.

Work Location: In person

Pay: ₹20,000.00 - ₹30,000.00 per month

Work Location: In person