Key Responsibilities
- Coordinate with TPAs, insurance companies, patients, doctors, billing and medical records departments.
- Handle cashless admission and pre-authorization processes.
- Prepare and submit pre-authorization requests with complete and accurate documentation.
- Follow up with TPAs/insurance companies for approval, enhancement and final authorization.
- Coordinate for cashless discharge approval and ensure timely processing.
- Verify insurance eligibility, policy details, coverage and applicable terms.
- Ensure proper collection and submission of required patient documents.
- Check medical records, investigation reports, prescriptions, bills and other documents required for claims.
- Coordinate with the billing team regarding insurance billing, deductions and claim settlements.
- Follow up on pending claims, queries, deductions and rejections.
- Maintain proper records of pre-authorizations, approvals, discharges, claims and settlements.
- Communicate professionally with patients and their attendants regarding insurance/TPA procedures.




- Resolve TPA-related queries and coordinate with concerned hospital departments for timely action.
- Ensure compliance with hospital policies, insurance guidelines and TPA requirements.
- Prepare daily/weekly/monthly TPA MIS reports and pending case reports.
- Identify documentation gaps and ensure timely correction to avoid claim delays or rejections.
- Maintain confidentiality of patient and insurance-related information.Required Skills:
- Robust knowledge of TPA, insurance and cashless hospitalization processes.
- Good understanding of hospital billing and claim documentation.
- Excellent communication and coordination skills.
- Good follow-up and problem-solving abilities.
- Proficiency in MS Office/Excel and hospital information systems (HIS).
- Ability to work under pressure and manage multiple cases simultaneously.
- Strong documentation and record-keeping skills.
- Patient-friendly and professional approach.
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📌 Tpa Co-ordinator (Patna)
🏢 Shri Sai Hospital
📍 Patna