Job Summary

The TPA Executive will be responsible for managing all insurance and Third-Party Administrator (TPA) related activities in the hospital. The role ensures smooth processing of cashless and reimbursement claims, coordination with insurance companies/TPAs, and assistance to patients for insurance documentation and approvals.

Key Responsibilities

- Act as the primary point of contact between the hospital and TPAs/insurance companies.

- Handle cashless insurance cases, including pre-authorization and final approval processes.

- Verify patient insurance eligibility, coverage limits, and policy conditions.

- Assist patients and attendants with insurance documentation and claim procedures.

- Coordinate with doctors, billing, and accounts departments for accurate claim processing.

- Submit complete claim documents to TPAs within defined timelines.





- Follow up with TPAs and insurance companies for pending approvals and settlements.

- Maintain accurate records of claims, approvals, denials, and settlements.

- Ensure compliance with hospital policies, TPA guidelines, and insurance norms.

- Update management on claim status, rejections, and escalations.

Qualifications & Skills

- Graduate in any discipline (Healthcare Administration preferred).

- Positive knowledge of TPA processes, health insurance policies, and cashless claims.

- Strong communication and coordination skills.

- Attention to detail and ability to handle multiple cases simultaneously.

- Working knowledge of MS Office and Hospital Management Systems (HMS).

📌 Doctor-TPA (New Delhi)
🏢 JEENA SIKHO LIFECARE
📍 New Delhi