Title
Officer – TPA
Location
Thane
Job Summary
Coordination with Head – Corporate relation and TPA Sr. Manager for all TPA related activity.
Job Profile
- Counselling patients and relatives for cashless procedure, eligibility of class as per policy T&C.; payment of non-medical expenses which not covered under policy.
- Collecting relevant documents for cashless, filling up of preauthorisation form, coordinating with treating doctor & ward RMO for getting relevant information for cashless procedure & query raised by the Insurance Co. / TPA.
- Coordinating with concerned Insurance Co. / TPA authority for getting approval letter, enhancement letter matching with total bill & updating Billing department about status of cashless sanctioned amount.
- Coordination with patient, Ward RMO,
transcriptionist & billing department at the time of discharge for preparation of final bill & discharge summary.
- Verifying & scrutinising the cashless claim file prepared by TPA executive, answering the post claim queries raised by Insurance Co. / TPA.
- Coordinating with billing department for refund of security deposit paid by patient.
- Coordinating with investigator & arranging the relevant letter for cashless procedure.
- Reply of post discharge query of cashless / reimbursement claim file.
Skills
Excellent verbal communication and the ability to convey information clearly and effectively.