DESIGNATION: Insurance/TPA Manager - Hospital

QUALIFICATION: Any Graduate

KEY SKILLS: Experience in healthcare industry especially hospital industry

YRS OF EXP: 4 to 6 Yrs

SALARY: As per Industry Standards

JOB DESCRIPTION:
Oversee all TPA and health insurance company relationships.
Ensure timely registration, empanelment, and renewal with various TPAs and insurers.
Negotiate service agreements and tariff rates with insurance providers and TPAs.
Supervise pre-authorization, billing, and claims submission processes.
Ensure timely and accurate documentation for claims approval.
Monitor and reduce claim rejections, denials, and delays.
Coordinate with billing and finance teams to ensure prompt payment realization.
Manage the insurance desk and ensure effective patient interaction during admission, discharge, and claim settlement.
Educate patients and families on insurance processes, eligibility, and documentation requirements.




Ensure adherence to IRDAI and regulatory requirements.
Maintain complete and accurate documentation for audits.
Prepare MIS reports related to TPA activities, claim status, and financial recovery.
Act as a liaison between hospital departments, TPAs, and insurers.
Resolve disputes or issues arising from delayed payments, claim rejections, or miscommunication.
Lead and manage the TPA/Insurance team.
Train staff on claim handling, software systems, documentation protocols, and customer service.
Analyze trends in claim rejection and implement corrective measures.
Suggest improvements in systems or processes to enhance claim turnaround time and revenue.

Note: Immediate Joiners Preferred

Job Type: Full time

Pay: ₹20,000.00 - ₹30,000.00 per month

Work Location: In person

📌 Insurance/tpa Manager Royapettah
🏢 Orthomed Hospitals
📍 Royapettah