TPA Manager / Executive Roles & Responsibilities

Role: TPA Manager / Executive/govt panel

Department: TPA / Insurance & Billing

Industry: Hospital / Healthcare

Key Responsibilities:

Manage end-to-end TPA and insurance claim processes, from patient admission to final claim settlement.

Coordinate with TPAs, insurance companies, corporate clients, and patients for cashless and reimbursement cases.

Handle pre-authorisation, enhancement requests, discharge approvals, and final settlement.

Ensure timely submission of complete and accurate claim documents to avoid delays and rejections.

Verify patient eligibility, policy coverage, approvals, and applicable deductions.

Coordinate with billing, medical, nursing, MRD, and other hospital departments for required documents.

Monitor pending claims, query cases, deductions, rejections, and claim outstanding.

Resolve discrepancies and follow up with TPAs/insurers for timely settlement.

Maintain proper TPA records, MIS reports, trackers, and documentation.

Ensure compliance with hospital policies,



insurance guidelines, and applicable regulatory requirements.

Supervise and guide TPA executives/team members, if handling a managerial position.

Analyze claim rejection/deduction trends and take corrective actions to improve collection and reduce revenue leakage.

Maintain qualified communication with patients and their attendants regarding insurance-related processes.

Preferred Candidate Profile:

Graduate / MBA / PG in Hospital Administration, Healthcare Management, or related field preferred.

Experience in hospital TPA/insurance/cashless operations.

Valuable knowledge of major TPAs, insurance processes, pre-authorisation, claim submission, and settlement.

Robust communication, coordination, documentation, and follow-up skills.

Proficiency in MS Excel and hospital/TPA software preferred.

For Manager: Prior experience in team handling and TPA department management is preferred.

📌 Walk In Tpa Manager/executive/govt Panel New Delhi
🏢 NKS HOSPITAL
📍 New Delhi