Job Description: Billing & TPA Executive
Shift: Rotational (Day / Night)
Core Responsibilities
Verify insurance eligibility and upload clinical estimates to TPA portals within 4 hours of admission.
Coordinate with doctors to resolve insurer medical queries and secure initial credit letters.
Maintain interim IPD bills, track pharmacy additions, and update families on non-payable items.
Submit incremental cost enhancement requests to TPAs when treatment protocols change.
Audit final bills against nursing charts and upload discharge summaries for final approval.
Index, bundle, and courier original medical files, bills, and implant barcodes to TPAs.
Track payment advice notes, flag short-payments, and file formal appeals for wrongful deductions.
Experience & Competencies
5+ years in hospital billing, corporate TPA desk, or health insurance operations.
Hands-on experience with HMIS software and TPA portals (e.g., Medi Assist, MDIndia, Paramount).
Robust understanding of medical terminology, ICD codes, and advanced MS Excel.