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.
Positive knowledge of cashless hospitalization and insurance claim procedures.
Experience in dealing with major TPAs and insurance companies.
Good 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.
Prospect to work in a growing hospital environment.
Qualified 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