We are looking for a proactive and detail-oriented TPA / Claims Settlement Executive to join our healthcare operations team in Vadodara. The ideal candidate will have experience handling health insurance claims, coordinating with hospitals and insurance companies, and ensuring timely claim settlement.
Key Responsibilities
Process cashless and reimbursement health insurance claims.
Coordinate with hospitals, insurance companies, and TPAs for claim approvals.
Verify patient documents and insurance eligibility.
Prepare and submit claim documentation accurately.
Follow up on pending claims and resolve discrepancies.
Handle claim settlement queries from patients and hospitals.
Maintain claim records and documentation.
Ensure compliance with insurance guidelines and company procedures.
Coordinate with internal departments for smooth claim processing.
Generate claim status reports and MIS when required.
Preferred candidate profile
Knowledge of health insurance claim procedures.
Familiarity with TPA operations.
Valuable documentation and verification skills.
Solid communication and coordination abilities.
Proficiency in MS Excel and MS Office.
Ability to work under deadlines.
High level of accuracy and attention to detail.