Job Description

Role Overview

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

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Key Roles and Responsibilities:

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- Responsible for TPA / Insurance Empanelment & renewals of contracts.
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- Responsible for periodical tariff revision & price negotiation with private & GIPSA insurance companies.
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- Responsible for timely recoveries of TPA Credit sales. (Collection & Deduction Recovery)
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- Liaoning with TPAs & Insurer key persons and relationship building.
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- Responsible for Rejection & Deduction follow ups.
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- Responsible for account reconciliation with internal & external customers.
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- Regular record updating of Insurance & Deduction Tracker
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- Periodic review of individual and departmental performance.
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- Defining the organizational goals, strategies, setting of internal monthly targets for collection & deductions.
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- Monitor, administer & training of the centralize team.
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- 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.
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- Performing troubleshooting during cashless approvals and pre & post-discharge of the patients for all units
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- Ensuring group's timely dispatch of credit invoices for payment recoveries
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- Reconciling accounts with all TPAs, Insurance Companies, and internal Finance Teams
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- 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
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- Following-up for deduction and rejection of the TPA claims; reviewing & analysing Debtor Ageing and Daily Collection Reports
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- Monitoring day to day work of team on receivable software i.e., Eprapti.
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- To define and set the centralized TPA process.
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- Motivating the team and responsible for high team morale.
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Experience & Qualifications:

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- Graduate, preferably with an MBA in Marketing or a Diploma in Marketing.
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- Preferably with 6 to 10 years of experience in healthcare of handling TPA / Insurance channel.
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- Solid Interpersonal skills and conflict resolution ability
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- Extremely strong Networking Skills
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- Good Organization and Planning Skills
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- Strong Relationship Management Skills
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- Strong focus on performance and Service Excellence
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📌 AGM/DGM (Health Insurance Administration & Receivables) Sales and Marketing (Noida)
🏢 Max Healthcare
📍 Noida