We are looking for a candidate to manage TPA, insurance, and corporate billing operations, including pre-authorizations, claim documentation, bill preparation, submission, follow-up, and coordination with TPAs, insurance companies, and corporate clients.

Role & responsibilities

- Handle TPA, insurance, and corporate patient billing processes.
- Coordinate with TPAs and insurance companies for patient admission and treatment approvals.
- Process pre-authorization requests and ensure timely approval.
- Prepare and verify patient bills as per approved packages, tariffs, and agreements.
- Ensure complete and accurate documentation for claim submission.
- Submit claims to respective TPAs/insurance companies within defined timelines.
- Track claim status and follow up on pending, rejected, or queried claims.
- Coordinate with doctors, nursing, pharmacy, diagnostics, billing, and other departments for required documents.
- Address billing discrepancies, queries, deductions, and claim-related issues.




- Maintain records of submitted claims, outstanding amounts, settlements, and rejections.
- Coordinate with corporate clients regarding billing and payment-related matters.
- Assist in reconciliation of TPA/corporate outstanding and settlement amounts.
- Prepare MIS reports related to TPA and corporate billing.
- Ensure compliance with hospital billing policies, TPA guidelines, and corporate agreements.

Preferred candidate profile

- Good knowledge of hospital billing and TPA processes.
- Understanding of health insurance and cashless hospitalization procedures.
- Knowledge of pre-authorization and claim settlement processes.
- Good MS Excel and MIS reporting skills.
- Solid coordination and follow-up skills.
- Good communication and interpersonal skills.
- Ability to work under deadlines and handle multiple cases simultaneously.

📌 Walk-in || Tpa Billing Executive (Nagpur)
🏢 VSPM Academy of Higher Education
📍 Nagpur