: Billing & TPA Executive

Shift: Rotational (Day / Night)

Core Responsibilities

- Verify insurance eligibility and upload clinical estimates to TPA portals within 4 hours of admission.
- Coordinate with doctors to resolve insurer medical queries and secure initial credit letters.
- Maintain interim IPD bills, track pharmacy additions, and update families on non-payable items.
- Submit incremental cost enhancement requests to TPAs when treatment protocols change.
- Audit final bills against nursing charts and upload discharge summaries for final approval.
- Index, bundle, and courier original medical files, bills, and implant barcodes to TPAs.
- Track payment advice notes, flag short-payments, and file formal appeals for wrongful deductions.

Experience & Competencies
- 5+ years in hospital billing, corporate TPA desk, or health insurance operations.
- Hands-on experience with HMIS software and TPA portals (e.g., Medi Assist, MDIndia, Paramount).
- Solid understanding of medical terminology, ICD codes, and advanced MS Excel.

Pay: ₹25,000.00 - ₹30,000.00 per month

Work Location: In person

📌 Billing & TPA Executive (Chembur)
🏢 Sushrut hospital
📍 Chembur