Key ResponsibilitiesClaim & Pre-Authorization Management
Processing pre-authorization requests for cashless treatments.
Reviewing medical documents to ensure policy compliance.
Submitting final claim files to insurance companies timely.
Resolving claim queries or discrepancies raised by insurers. [1, 2, 3, 4]
Hospital Billing Coordination
Preparing accurate In-Patient Department (IPD) and Out-Patient Department (OPD) bills.
Verifying medical charges, doctor fees, pharmacy items, and implant costs.
Checking co-payment rules, room rent capping, and non-medical exclusions.
Reconciling outstanding payments from diverse TPA companies. [1, 2, 3, 4]
Patient Care & Communication




Counseling patients regarding their specific insurance coverage limits.
Assisting with hospital entry and discharge formalities smoothly.
Addressing patient queries regarding deduction or claim rejection reasons. [1, 2, 3, 4]
dministration & Portal Management
Operating diverse TPA portals to track real-time claim status.
Maintaining up-to-date knowledge of healthcare insurance norms and ICD codes.
Generating monthly review reports tracking settlement efficiency. [1, 2, 3]

Pay: ₹12,000.00 - ₹22,000.00 per month

Work Location: In person

📌 Tpa Executive Mayur Vihar Phase 3 (New Delhi)
🏢 DR SANKHWAR HOSPITAL
📍 New Delhi