Role & responsibilities

The incumbent will manage health insurance claims and patient billing. He/She will bridge the gap between patients, healthcare providers, and insurance companies to facilitate cashless authorizations, process reimbursements, and ensure compliance with medical policies.

Preferred candidate profile

Assistant/Sr. Assistant - TPA (2-4 yrs of work experience)

Assistant Manager - TPA (5-10 yrs of work experience)

- Claim Processing: Assist in the preparation, verification, and submission of cashless and reimbursement claims to TPAs and insurance companies.
- Patient Coordination: Guide patients and their families through insurance eligibility, coverage details, and approval statuses.
- Pre-Authorizations: Facilitate initial authorizations for planned treatments and emergency procedures.
- Document Management: Collect, scan, and dispatch medical files, diagnostic reports,



and final bills to the appropriate authorities.
- Dispute Resolution: Follow up on pending files, outstanding amounts, and claim rejections while resolving any discrepancies.
- Key Skills Required

- Medical Billing: Proficiency in navigating TPA portals and understanding different insurance packages (e.g., corporate, CGHS, ECHS).
- Communication: Ability to negotiate and clearly explain insurance jargon to patients while coordinating effectively with hospital staff.
- Attention to Detail: High accuracy in data entry and verifying documents to prevent claim rejections.

Interested candidates can apply their resumes on [email protected]

📌 Assistant/Senior Assistant/Assistant Manager - TPA (Gurugram)
🏢 Fortis
📍 Gurugram