- Handle end-to-end TPA, Insurance and Cashless Claim processes.
- Coordinate for pre-authorization, approval, enhancement, discharge approval and final claim submission.
- Handle ECHS, CGHS, Ayushman Bharat (PM-JAY) and other panel cases.
- Verify patient eligibility, documents, insurance coverage and required approvals.
- Coordinate with doctors, billing, medical records and other departments for claim documentation.
- Follow up with TPAs/insurance companies for pending approvals, queries, deductions and settlements.
- Resolve patient/attendant queries related to cashless treatment and claims.
- Maintain records of approved, pending, rejected and settled claims.
- Prepare daily/monthly TPA MIS and outstanding reports.
- Ensure timely and accurate submission of claims as per TPA/panel guidelines.
Qualification & Experience:
- Graduate in any discipline; Hospital Administration/Healthcare Management preferred.
- 2–5 years of relevant experience in TPA, insurance, hospital billing or cashless claims.
- Positive communication, coordination and MS Excel skills.
- Knowledge of TPA, ECHS, CGHS and Ayushman Bharat processes preferred
Can Apply-(phone hidden) Pay: ₹20,000.00 - ₹22,000.00 per month