Role: TPA Head / Insurance & TPA Manager

Department: Insurance / TPA / Billing

Reports to: Hospital Administration / Operations Head

Key Responsibilities

- Manage the complete TPA and health-insurance desk operations.
- Handle patient pre-authorizations, cashless approvals, extensions, and final approvals.
- Coordinate with TPAs, insurance companies, patients, doctors, billing, and medical records teams.
- Ensure timely submission of claims and supporting documents.
- Monitor claim rejection, deductions, queries, and pending claims and take corrective action.
- Supervise TPA executives and allocate daily work.
- Maintain accurate records of cashless and reimbursement cases.
- Coordinate with billing and finance teams for claim reconciliation and payment follow-up.
- Ensure compliance with hospital policies, insurer/TPA requirements, and applicable regulations.
- Prepare MIS reports on admissions, approvals, claims submitted,



outstanding amounts, rejections, and collections.
- Resolve escalated patient and insurance-related issues.
- Train and guide staff on insurance/TPA processes.
- Develop positive working relationships with major insurance companies and TPAs.

Key Skills

- Hospital insurance/TPA operations
- Cashless hospitalization process
- Claim management and reconciliation
- Team management
- Negotiation and communication
- Knowledge of hospital billing
- MS Excel/MIS reporting
- Problem-solving and coordination

Typical Qualification

- Graduate degree;
- Relevant experience in hospital TPA/insurance operations, preferably in a supervisory or managerial role.

Pay: ₹30,000.00 - ₹50,000.00 per hour

Work Location: In person

📌 TPA Head (Chandigarh)
🏢 Eden Hospital
📍 Chandigarh