We are looking for an experienced and responsible TPA Coordinator to manage insurance and TPA-related activities for hospital patients. The candidate will be responsible for coordinating cashless approvals, documentation, pre-authorizations, claim processing, billing coordination, and communication with TPAs, insurance companies, patients, and the hospital team.

Key Responsibilities

- Coordinate with TPAs, insurance companies, and corporate clients for patient admissions and treatment approvals.
- Handle cashless hospitalization and reimbursement-related processes.
- Prepare and submit pre-authorization requests with complete and accurate documentation.
- Follow up regularly with TPAs/insurance companies for approval status.
- Coordinate with doctors, billing, medical records, and patient-care teams to collect required documents.
- Ensure timely submission of treatment estimates, medical records, investigation reports, prescriptions, discharge summaries, and other required documents.
- Handle queries raised by TPAs and insurance companies and coordinate for timely resolution.
- Monitor approval, enhancement, discharge approval, and final authorization processes.




- Coordinate with the billing team regarding approved amounts, deductions, co-payments, and non-payable items.
- Verify patient insurance/TPA eligibility and coverage details.
- Maintain proper records of all TPA cases, approvals, pending cases, queries, and settlements.
- Follow up on pending claims and ensure timely submission of required documents.
- Coordinate with patients and their attendants regarding TPA procedures, documentation, and approval status.
- Identify discrepancies in documentation and get them corrected promptly.
- Maintain confidentiality of patient and insurance-related information.
- Prepare daily/weekly/monthly TPA reports for management.
- Ensure compliance with hospital policies, TPA guidelines, and applicable documentation requirements.
- Coordinate with the accounts and billing departments for claim settlement and reconciliation.
- Maintain good qualified relationships with TPA representatives and insurance coordinators.

Pay: ₹10,000.00 - ₹35,000.00 per month

Work Location: In person

📌 TPA Executive (Sahibzada Ajit Singh Nagar)
🏢 7 Whole Essentials
📍 Sahibzada Ajit Singh Nagar