Role & responsibilities

- Manage the overall functioning of the hospital's TPA/Insurance Department.
- Coordinate with various insurance companies, TPAs, corporate clients, and other stakeholders.
- Handle the complete cashless hospitalization process from admission to discharge.
- Coordinate for pre-authorization and obtain timely approvals from TPAs/insurance companies.
- Ensure accurate submission of required medical and billing documents.
- Follow up on pending approvals, queries, enhancements, and final authorizations.
- Coordinate with doctors, nursing staff, billing, medical records, and other hospital departments.
- Verify patient insurance eligibility and coverage details.
- Ensure proper documentation for cashless and reimbursement claims.
- Handle queries and discrepancies raised by TPAs or insurance companies.
- Monitor discharge approvals and ensure timely completion of the discharge process.
- Coordinate with the billing department for correct billing as per approved amounts and insurance terms.
- Track pending claims, deductions, rejected claims, and outstanding amounts.
- Maintain proper records and MIS reports related to TPA cases.
- Monitor departmental performance, pending cases, approval turnaround time,



and claim status.
- Resolve patient and attendant queries related to insurance/TPA procedures.
- Ensure compliance with hospital policies, insurance guidelines, and applicable processes.
- Identify recurring issues and coordinate with concerned departments for corrective action.
- Maintain qualified relationships with TPA representatives, insurance companies, and corporate clients.
- Train and guide TPA desk staff on hospital processes and documentation requirements.
- Ensure confidentiality and proper handling of patient and insurance-related information.
- Prepare regular reports for hospital management regarding TPA performance and pending cases.

Preferred candidate profile

- Graduate in any discipline.
- Degree/Diploma in Hospital Management, Healthcare Management, Insurance, or a related field will be an advantage.
- Candidates with relevant hospital, TPA, insurance, billing, or healthcare experience will be preferred.

Experience Candidate must have 7 to 10 years of experience in hospiotal marketing & TPA work [email protected] whatsapp: (phone hidden)

📌 Marketing Manager/TPA (Lucknow)
🏢 Era University
📍 Lucknow