Responsibilities:
- Handling TPA related all process from billing to co-ordinate with TPA companies.
- Responsible for counseling patient's family & pre-Auth process.
- Maintaining & uploading patient's files on the portal.
- Couriering the hard copy of patient's medical file to the Insurance companies.
- Responsible for all co-ordination activities from patient's admission to discharge.
- Handling billing Department, Implants bill updating & reconciliation.
- Daily co-ordination with the patient and Hospital staff.
- Preparing split bills/ Doctor charges etc.
- Handling all TPA Portals.
- Outstanding follow-up with TPA.
- Monthly Review report.
- To obtain and review referrals and authorizations for treatments.
- To follow and adhere to all regulations and guidelines set by state programs, and HMO/PPO, etc.
- Must be aware of norms of the insurance sector.
- Daily follow up with Insurance companies to pass or clear the Health Insurance claims.