Role Overview:
Key Responsibilities:
- Handle end-to-end TPA / Insurance processes including cashless and reimbursement cases
- Manage IPD & OPD billing, ensuring accuracy and compliance with hospital policies
- Coordinate with TPAs and insurance companies for pre-authorizations and approvals
- Strong understanding of hospital billing, treatment packages, and medical coding.
- Handle queries, discrepancies, and rejection management from TPAs/insurers
- Ensure timely submission of documents for claim processing
- Maintain proper documentation and records for audit and compliance
- Work closely with internal teams (billing, medical, operations) for smooth case handling
- Use and manage Hospital Information System (HIS) effectively for billing and claims
- Build and maintain strong liaisoning with insurance companies and TPAs

Required Skills & Competencies:
- Strong knowledge of TPA / Insurance workflows
- Good understanding of IPD & OPD billing processes




- Expertise in query handling & rejection resolution
- Familiarity with HIS (Hospital Information System)
- Positive communication and coordination skills
- Attention to detail and problem-solving ability
- Ability to work in a fast-paced hospital environment

Qualifications:
- Graduate in any discipline (Healthcare/Hospital Administration preferred)
- Certification or training in Medical Billing / Insurance is an added advantage Preferred Experience:Experience in multi-specialty hospitals / healthcare setups Hands-on exposure to cashless billing and insurance approvals

Pay: ₹9,759.52 - ₹35,000.00 per month

Benefits:
- Cell phone reimbursement
- Commuter assistance
- Food provided
- Health insurance
- Leave encashment
- Provident Fund

Work Location: In person

📌 Tpa Executive (Sohna)
🏢 Pristyn Care
📍 Sohna