24 Oct
|
MedsCred
|
Bengaluru
24 Oct
MedsCred
Bengaluru
Key Responsibilities (KRAs)
• Patient Counselling & Guidance: Counsel patients and their families regarding health
insurance coverage, co-pay clauses, non-payable items, pre-authorization procedures,
and overall claim process timelines to set explicit expectations.
• Hospital TPA Helpdesk Management: Manage day-to-day operations at the dedicated
TPA / Health Insurance Helpdesk within partner hospitals.
• Cashless Claim Processing: Assist patients with pre-authorization paperwork, submit
initial requests, and coordinate cashless approvals with TPAs and insurance providers.
• Hospital Coordination: Work closely with hospital admission desks, billing departments,
and medical records teams to gather required discharge summaries, itemized bills, and
diagnostic reports.
• Query Resolution: Promptly address and resolve queries or deficiency letters raised by
TPAs/Insurers to prevent authorization or settlement delays.
• Documentation & Tracking: Maintain accurate daily tracking logs of patient admissions,
approvals, rejections, and pending query statuses.
Candidate Eligibility & Requirements
• Must-Have Experience: Direct experience working at a Hospital Helpdesk TPA or inside
a Hospital TPA/Insurance Desk is MANDATORY.
• Patient Counselling Skills: Proven ability to counsel patients empathetically, address
their concerns calmly, and explain complex insurance terms clearly.
• Experience Duration: Minimum 8 months to 1 year of hands-on experience in
healthcare claims or TPA operations.
• TPA Background: Prior experience working with top TPA companies or within hospital TPA cells.
• Domain Knowledge: Strong understanding of health insurance claim workflows, pre
authorization forms, medical terminology, and billing documentation requirements.
• Communication Skills: Transparent verbal communication and robust interpersonal skills in
English and Kannada (Hindi is an added advantage) to interact comfortably with patients,
hospital administration, and insurance auditors.
📌 Executive Claim Operations Hospital Tpa Desk Bengaluru
🏢 MedsCred
📍 Bengaluru