Job Description TPA / Billing Executive

Company: Nexus Pain Management
Department: Accounts / Operations
Position: TPA / Billing Executive
Reports To: Center Manager / Operations Manager

Job Summary

Nexus Pain Management is looking for a detail-oriented and experienced TPA / Billing Executive to manage patient billing, insurance/TPA coordination, pre-authorizations, claims, and payment follow-ups. The candidate will ensure accurate billing and smooth coordination between patients, doctors, insurance companies, and internal departments.

Key Roles & Responsibilities
- Handle patient billing and ensure accurate preparation of bills and invoices.
- Coordinate with TPA and insurance companies for cashless approvals and claim processing.
- Prepare and submit documents for pre-authorization, enhancements, and final approvals.
- Follow up with insurance companies and TPAs for pending approvals and claims.
- Verify patient insurance eligibility, policy coverage, and required documentation.
- Coordinate with patients regarding insurance documents, co-payments, deductions,



and non-covered expenses.
- Maintain proper records of approved, pending, rejected, and settled insurance claims.
- Handle billing corrections, cancellations, refunds, and payment reconciliation as per company policy.
- Coordinate with the Front Office, Doctors, Finance, and Operations teams for smooth patient discharge and billing.
- Ensure all billing and TPA documentation is completed accurately and within the required TAT.
- Prepare daily/monthly reports related to billing, collections, pending claims, and insurance settlements.
- Maintain confidentiality of patient and financial information.
- Resolve patient queries related to bills, insurance approvals, and payments professionally.

Candidate Requirements
- Any Graduate or relevant qualification in Healthcare/Hospital Administration, Finance, or Accounts.
- Experience in Hospital Billing, TPA, Insurance, or Cashless Claims is preferred.
- Knowledg

📌 TPA/ Billing Executive (Bengaluru)
🏢 Nexus pain management center
📍 Bengaluru