A TPA (Third-Party Administrator) Executive in a hospital acts as the crucial link between patients, insurance companies, and the hospital, managing insurance claims, pre-authorizations, and discharge processes. They ensure smooth cashless transactions, verify documentation for compliance, and provide guidance to patients regarding insurance advantages. Indeed +2Key Responsibilities:
Cashless Claims Management: Initiating, monitoring, and obtaining approval for cashless treatment requests from TPAs and insurance companies, ensuring they are handled within defined timelines.
Patient Counseling & Documentation: Verifying patient insurance eligibility, guiding families on policy coverage, and organizing necessary documentation (ID proof, health cards, doctor reports).
Billing & Coordination: Collaborating with the hospital billing department for bill reconciliation, preparing final invoices for TPA submission, and handling queries at discharge.
TPA Portal Handling: Maintaining patient records, uploading documents,



and updating claim statuses accurately on various TPA portals.
Follow-ups & Reporting: Conducting follow-ups on pending approvals or payments and preparing daily/monthly reports on claim status for hospital management.
Dispute Resolution: Addressing disputes or rejections regarding insurance claims between the insurer and the hospital. Indeed +4

Skills and Qualifications:
Education: Bachelor’s degree in any discipline or experience in healthcare administration.
Experience: Usually 1–3 years of experience in hospital billing or TPA departments.
Skills: Robust communication, interpersonal skills, proficiency in hospital information systems (HIS), and knowledge of medical terminology and insurance norms. Indeed +4

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Job Type: Full time

Pay: ₹12,000.00 - ₹25,000.00 per month

Experience:
total work: 1 year (Preferred)

Work Location: In person

📌 Tpa Manager/ Excutive Muzaffarpur (India)
🏢 Tirhut Central Hospital
📍 India