We are looking for an experienced TPA Coordinator to manage and coordinate insurance/TPA-related processes, including cashless approvals, pre-authorizations, claim documentation, discharge approvals, and coordination with insurance companies and Third-Party Administrators. The candidate should have robust knowledge of hospital billing, insurance procedures, and TPA documentation.
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
Solid knowledge of TPA, insurance and cashless hospitalization processes.
Valuable understanding of

📌 Tpa Co Ordinator Patna
🏢 Shri Sai Hospital
📍 Patna