TPA Coordinator

Department: Billing & Insurance
Reports To: Billing Manager / Finance Manager / Hospital Administrator
Location: Hopewell Hospital, Ranchi
Employment Type: Full time

Position Summary

The TPA Coordinator is responsible for the complete management of cashless insurance, corporate, government health schemes, and reimbursement cases. The role ensures timely pre-authorizations, accurate documentation, effective coordination with insurance companies and TPAs, prompt claim settlements, and an excellent patient experience throughout the hospitalization.

The coordinator acts as the bridge between patients, doctors, nursing, billing, insurance companies, TPAs, and internal hospital departments.

Key Responsibilities
Cashless Admission Management
Verify patient's insurance eligibility.
Check policy coverage and exclusions.
Explain cashless process to patients and relatives.
Coordinate with admission desk before admitting insured patients.
Obtain all necessary insurance documents.
Pre-Authorization
Prepare and submit pre-authorization requests.




Coordinate with consultants for clinical documents.
Follow up continuously until approval.
Escalate delayed approvals.
Maintain approval timelines.
Documentation

Collect and verify:
Insurance card
Identity proof
Policy copy
Claim forms
KYC documents
Consultant notes
Investigation reports
Consent forms
OT notes
Discharge summary
Final bill
Pharmacy records
Implant stickers
Investigation films/reports

Ensure zero documentation deficiencies.
Insurance Coordination

Coordinate with:
TPAs
Insurance Companies
Corporate Insurance Panels
Government Health Schemes
Surveyors
Medical Auditors

Maintain skilled communication throughout the patient journey.
Billing Coordination

Work closely with billing team to ensure:
Accurate package billing
Non-payable identification
Excluded items explained to patient
Timely bill updates
Final bil

📌 Tpa Coordinator Ranchi
🏢 Hopewell Hospital
📍 Ranchi