Job Description – TPA Executive (Ayushman Bharat & Reception)

Position: TPA Executive (Ayushman Bharat & Reception)
Department: TPA / Front Office
Location: Hospital

Job Summary

The TPA Executive will be responsible for managing cashless insurance and Ayushman Bharat (PM-JAY) processes while also handling front office and reception responsibilities. The candidate should ensure smooth patient registration, insurance documentation, pre-authorizations, claim coordination, and provide excellent patient service.

Key ResponsibilitiesTPA & Ayushman Bharat
Handle all TPA and cashless insurance processes.
Manage complete Ayushman Bharat (PM-JAY) patient registration and verification.
Verify patient eligibility on the Ayushman portal.
Coordinate pre-authorization, approvals, and claim submissions.
Prepare and maintain complete documentation for insurance and Ayushman cases.
Track pending approvals, claim status, and settlements.
Resolve TPA and Ayushman-related patient queries.
Ensure compliance with hospital policies and government guidelines.




Maintain records and prepare daily/monthly TPA and Ayushman reports.

Reception & Front Office
Welcome and assist patients and visitors professionally.
Register OPD/IPD patients and generate UHID.
Handle appointments and patient inquiries.
Guide patients regarding hospital services and admission procedures.
Answer telephone calls and provide accurate information.
Maintain reception records and patient data confidentially.
Handle billing coordination whenever required.

Required Qualifications
Graduate in any discipline.

Experience
2–5 years of experience in Hospital TPA, Ayushman Bharat (PM-JAY), and Front Office operations.
Experience working in a multi-speciality hospital is preferred.

Required Skills
Robust knowledge of Ayushman Bharat (PM-JAY) portal and processes.
Valuable understanding of TPA, cashless claims, and medical insurance.
Knowledge of hospital billing and documentation.
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📌 Tpa And Receptionist Lucknow
🏢 SANJIVINI HOSPITAL & RESEARCH CENTER
📍 Lucknow