JOB DESCRIPTION (JD)Position: TPA Executive / TPA Coordinator

Organization: PULMONIC A Multispecialty Hospital
Location: R-9/1, Raj Nagar, Ghaziabad – 201002
Department: TPA / Insurance / Billing
Job Type: Full time

Job Summary

We are looking for an experienced and responsible TPA Executive to manage the complete process of insurance, TPA, CGHS and government health scheme patients. The candidate will be responsible for coordination with insurance companies, TPAs, CGHS authorities, hospital departments and patients to ensure smooth admission, cashless authorization, claim processing and settlement.

Key Responsibilities
- Handle TPA, Insurance, CGHS and Ayushman Bharat (PM-JAY) patient cases.
- Manage the complete cashless admission and discharge process.
- Coordinate with various TPAs, Insurance Companies and Government Health Schemes.
- Process Pre-Authorization / Pre-Approval requests for planned and emergency admissions.
- Prepare and submit all required documents for cashless approval.
- Coordinate with doctors, nursing staff, billing and medical records departments.




- Verify patient documents, insurance eligibility and scheme-related requirements.
- Handle CGHS beneficiaries and CGHS-related documentation and billing procedures.
- Handle Ayushman Bharat / PM-JAY cases, including eligibility, authorization and claim-related documentation.
- Prepare and submit final bills, discharge summaries, investigation reports and other required documents.
- Follow up on pending approvals, queries, rejections and claim settlements.
- Coordinate with TPA/Insurance representatives for queries and additional document requirements.
- Maintain proper records of all TPA, Insurance, CGHS and Ayushman cases.
- Ensure timely submission of claims and proper documentation.
- Handle patient and attendant queries professionally.
- Maintain confidentiality of patient and hospital records.
- Perform any other duties assigned by the management.

Required Skills & Qualifications
- Gradua

📌 TPA Executive (Ghaziabad)
🏢 PULMONIC A Multispecialty Hospital
📍 Ghaziabad