Third Party Administrator (Gurugram)

Third Party Administrator (Gurugram)

18 Oct
|
Sat Kartar Shopping
|
Gurugram

18 Oct

Sat Kartar Shopping

Gurugram

Job Summary:

Satkartar Sanjeevan Hospital is looking for an experienced Third Party Administrator (TPA Executive) to manage insurance and TPA operations efficiently. The ideal candidate should have hands-on experience in handling cashless approvals, insurance claims, reimbursement processes, and coordinating with insurance companies, TPAs, patients, and internal hospital departments.

Key Responsibilities

- Handle end-to-end TPA and insurance claim processes.
- Coordinate with insurance companies and TPAs for cashless approvals and claim settlements.
- Process pre-authorizations, reimbursements, and final claim submissions.
- Verify patient insurance eligibility and policy coverage.
- Ensure timely submission of all claim-related documents.
- Follow up with TPAs and insurance providers to resolve pending claims and queries.
- Coordinate with doctors, billing, admissions, and patients regarding insurance documentation.
- Maintain accurate records of approvals, rejections, and pending claims.




- Ensure compliance with hospital policies and insurance guidelines.
- Prepare daily, weekly, and monthly MIS reports related to TPA and insurance operations.

Required Skills

- Strong knowledge of TPA operations and health insurance processes.
- Experience in cashless hospitalization and reimbursement claims.
- Positive understanding of hospital billing and medical documentation.
- Excellent communication and coordination skills.
- Strong analytical and problem-solving abilities.
- Proficiency in MS Excel, MS Word, and Hospital Information Systems (HIS).

Preferred Qualifications

- Bachelor's degree in any discipline.
- 2–5 years of experience in TPA/Insurance Operations within a hospital.
- Familiarity with major TPAs and health insurance companies.

Work Location: In person

Pay: ₹20,000.00 - ₹30,000.00 per month

Work Location: In person

📌 Third Party Administrator (Gurugram)
🏢 Sat Kartar Shopping
📍 Gurugram

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