TPA Executive

Job Description – (Private Insurance Company Experience)

Company: Satkartar Sanjeevan Hospital
Department: Insurance Operations
Experience: 2–5 Years
Work Location: In-person

Job Summary

Satkartar Sanjeevan Hospital is looking for an experienced Insurance Executive with prior work experience in a private health insurance company. The ideal candidate should have hands-on experience in health insurance operations, policy processing, claims management, cashless approvals, reimbursement claims, and coordination with hospitals, healthcare providers, and insurance stakeholders.

Candidates who have worked in private health insurance companies are preferred. Candidates with only hospital-based TPA experience will not be the primary preference.

Key Responsibilities

- Handle health insurance claims, including cashless and reimbursement processes.
- Process and review insurance claims as per company policies and guidelines.
- Coordinate with hospitals, healthcare providers, and internal teams for claim-related matters.
- Verify policy coverage, patient eligibility, and insurance documentation.
- Review medical documents and claim details for accuracy and completeness.
- Follow up on pending claims, queries, rejections, and settlement status.




- Resolve claim-related discrepancies and coordinate with the concerned teams.
- Ensure timely processing and submission of claim-related documents.
- Maintain accurate records of claims, approvals, settlements, and pending cases.
- Prepare daily, weekly, and monthly MIS reports related to insurance operations.

Required Skills

- Strong knowledge of private health insurance operations and claim processing.
- Hands-on experience in cashless claims, reimbursement claims, and policy coverage.
- Understanding of medical documentation and health insurance procedures.
- Valuable communication, coordination, and problem-solving skills.
- Proficiency in MS Excel, MS Word, and insurance-related software systems.

Preferred Qualifications

- Bachelor's degree in any discipline.
- 2–5 years of experience in a private health insurance company.
- Experience in health insurance claims, policy servicing, or claims assessment.
- Familiarity with health insurance policies, claim settlement procedures, and insurance documentation.

Important: Candidates must have prior experience working with a private health insurance company. Hospital TPA desk experience alone will not be preferred.

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

Work Location: In person

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