Key Responsibilities (JD Key Result Areas - KRAs)

- Final Bill Settlement (Cashless): Coordinate with the TPA and hospital billing desk at the time of patient discharge to verify approved amounts, sign-off figures, and handle shortfalls. [1, 2]
- Reimbursement & Batch Reconciliation: Ingest TPA batch settlement sheets, match individual patient IDs and claim references, and reconcile payments against hospital ledger accounts. [1]
- Deduction & Shortfall Analysis: Identify and classify claim deductions—such as co-pay shortfalls, non-payable/disallowed items, room-rent capping, and TDS deductions (e.g., Section 194J at 10%). [1]
- Query & Rejection Handling: Resolve pending queries, coordinate missing medical documentation, and escalate delayed or improperly rejected claims with insurance companies and TPAs. [1, 2]
- MIS & Reporting: Maintain daily/monthly trackers for settled claims, outstanding receivables, aging reports, and revenue leakage analysis.

Pay: ₹30,000.00 - ₹35,000.00 per month

Work Location: In person

📌 TPA Co-ordinator - Settlement (Chembur)
🏢 Zen Multi Speciality Hospital
📍 Chembur