A TPA (Third-Party Administrator) Executive manages health insurance claims, pre-authorizations, and billing between patients, hospitals, and insurance companies. Key duties include verifying coverage, processing cashless/reimbursement claims, updating TPA portals, and ensuring timely claim settlements while providing customer service to patients.

Key Responsibilities

- Claim Processing : Handling cashless claim processes from admission to discharge, including preparing bills, updating implants, and reconciling accounts.
- Pre-Authorization : Obtaining and reviewing approvals for planned treatments and surgeries from insurance providers.
- Documentation & Portals : Maintaining accurate medical records, scanning documents, and managing TPA portals for updates.
- Coordination : Acting as the primary liaison between patients, hospital staff, and insurance companies for smooth service delivery.
- Patient Support : Advising patients on insurance benefits, coverage limits,



and resolving queries regarding claims.

Required Skills and Qualifications

- Experience : Freshers Can Apply.
- Education : Bachelor’s degree in any discipline.
- Knowledge : Strong understanding of insurance policies, guidelines, and medical terminology.
- Technical Skills : Proficiency in TPA portals and hospital information systems (HIS).
- Communication : Excellent interpersonal skills to handle patient counseling and insurance coordination.

Job Types : Full time, Permanent

Pay: ₹12,000.00 - ₹15,000.00 per month

Benefits :

- Paid sick time
- Paid time off
- Provident Fund

Ability to commute/relocate:

- Kalyan, Maharashtra: Reliably commute or planning to relocate before starting work (required)

Experience :

- TPA AT HOSPITAL: 1 year (required)

Work Location: In person

📌 Tpa Coordinator (Kalyan)
🏢 Oasis Hospital
📍 Kalyan