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