Role Overview

The Candidate will be responsible for overseeing and monitoring end-to-end health insurance / TPA process & credit sales & Collection channel across Max Healthcare.

Key Roles and Responsibilities:

- Responsible for TPA / Insurance Empanelment & renewals of contracts.- Responsible for periodical tariff revision & price negotiation with private & GIPSA insurance companies.- Responsible for timely recoveries of TPA Credit sales. (Collection & Deduction Recovery)- Liaoning with TPAs & Insurer key persons and relationship building.- Responsible for Rejection & Deduction follow ups.- Responsible for account reconciliation with internal & external customers.- Regular record updating of Insurance & Deduction Tracker- Periodic review of individual and departmental performance.- Defining the organizational goals, strategies, setting of internal monthly targets for collection & deductions.- Monitor, administer & training of the centralize team.- Regular visits & meeting with internal customers of the group such as TPA Desk, Finance & Accounts, Front Office,



and Bill Dispatch Departments; ensuring smooth functioning of the TPA Process.- Performing troubleshooting during cashless approvals and pre & post-discharge of the patients for all units- Ensuring group’s timely dispatch of credit invoices for payment recoveries- Reconciling accounts with all TPAs, Insurance Companies, and internal Finance Teams- Directing on-account (NEFT) settlement for ensuring timely settlement of NEFT payments, creating departmental MIS, reports, and presentations pertaining to TPA revenue, debtors aging, collection, deduction, old payment & NEFT (on-account) settlement for periodic review of team with higher management- Following-up for deduction and rejection of the TPA claims; reviewing & analysing Debtor Ageing and Daily Collection Reports- Monitoring day to day work of team on receivable software i.e., Eprapti.- To define and set the centralized TPA process.- Motivating the team and responsible for high team morale.

Experience & Qualifications:

- Graduate, preferably with an MBA in Marketing or a Diploma in Marketing.- Preferably with 6 to 10 years of experience in healthcare of handling TPA / Insurance channel.- Strong Interpersonal skills and conflict resolution ability- Extremely robust Networking Skills- Good Organization and Planning Skills- Strong Relationship Management Skills- Strong focus on performance and Service Excellence

📌 AGM/DGM (Health Insurance Administration & Receivables) Sales and Marketing (Mumbai)
🏢 Max Healthcare
📍 Mumbai