ey Responsibilities

- Manage cashless and reimbursement TPA/insurance cases from admission to final settlement.
- Coordinate with various TPAs, insurance companies, and corporate clients.
- Handle pre-authorisation, enhancement requests, final approvals, and discharge approvals.
- Ensure timely submission of required medical documents and bills.
- Follow up on pending approvals, queries, deductions, and claim settlements.
- Coordinate with doctors and clinical departments for required medical documents, summaries, and clarifications.
- Verify patient eligibility, policy details, coverage, and TPA requirements.
- Ensure accurate preparation and submission of bills and claim documents.
- Monitor TPA receivables and outstanding claims and follow up for timely payment.
- Maintain proper records of all TPA/insurance cases and their status.
- Identify and resolve claim-related discrepancies, deductions, and rejections.
- Coordinate with the billing, front office, medical records, accounts, and operations teams.
- Maintain daily/weekly/monthly TPA reports and MIS.
- Ensure compliance with hospital policies and TPA/insurance guidelines.
- Handle patient and attendant queries related to insurance and cashless procedures.
- Support management in improving TPA processes, reducing claim delays,



and minimizing revenue leakage.

Requirements
- Graduate in any discipline; healthcare/hospital administration qualification will be an advantage.
- 2–5 years of relevant experience in hospital TPA/insurance department.
- Good knowledge of cashless hospitalization and insurance claim procedures.
- Experience in dealing with major TPAs and insurance companies.
- Positive communication and coordination skills.
- Strong knowledge of hospital billing and documentation.
- Good computer skills, particularly MS Excel and hospital software.
- Ability to manage multiple cases and follow up systematically.
- Candidates with experience in a hospital TPA department will be preferred.

Key Skills

TPA Management | Insurance Claims | Cashless Approval | Pre-Authorization | Hospital Billing | Claim Settlement | Receivables | MIS Reporting | Patient Coordination | Insurance Coordination | MS Excel

What We Offer

- Competitive salary based on experience and capability.
- Opportunity to work in a growing hospital environment.
- Professional growth and learning opportunities.
- Responsible managerial role with coordination across hospital departments.

Pay: Up to ₹45,000.00 per month

Work Location: In person

📌 Senior Executive / TPA Manager (Ambala)
🏢 Shri Sai Hospital
📍 Ambala