We’re Hiring: TPA Executive – Health Insurance & Claims Management

Experience Required: Minimum 3 Years
Company: Yukti Herbs – Multi-Speciality Ayurveda & Panchakarma Hospital
Location: Mohali, Punjab

About the Role

Yukti Herbs is looking for an experienced and proactive TPA Executive to manage the complete health insurance process for patients opting for both cashless and reimbursement facilities.

The candidate should have robust practical knowledge of health insurance policies, claim procedures, pre-authorizations, documentation, and coordination with insurance companies and Third-Party Administrators (TPAs).

We are particularly looking for someone who has established professional contacts and good working relationships with insurance companies and TPAs, enabling smoother coordination, faster query resolution, and efficient claim processing.

Key Responsibilities

1. Insurance Policy Verification & Eligibility

- Understand and review patients’ health insurance policies.
- Verify policy coverage, exclusions, waiting periods, sub-limits, and eligibility for treatment.
- Identify whether the patient is eligible for cashless treatment or reimbursement.
- Explain insurance coverage and claim procedures to patients and their families.

2. Cashless Insurance Claims

- Coordinate with insurance companies and TPAs for cashless treatment approvals.
- Prepare and submit pre-authorization requests with all necessary medical documents.
- Follow up on pending approvals, queries, and additional document requirements.
- Coordinate with the hospital team to facilitate timely approvals.
- Handle claim enhancements, final authorization, and discharge-related formalities.

3. Reimbursement Claims





- Guide patients regarding reimbursement eligibility and documentation requirements.
- Assist in preparing and organizing medical records, bills, prescriptions, discharge summaries, and other supporting documents.
- Ensure patients receive the necessary documents for reimbursement submission.
- Coordinate with insurance companies regarding claim status, queries, and pending documentation.
- Follow up on reimbursement claims until their resolution.

4. Insurance Company & TPA Coordination

- Maintain strong professional relationships and regular communication with insurance companies and TPAs.
- Have established industry contacts to facilitate smooth coordination and faster resolution of insurance-related matters.
- Handle queries, clarifications, and claim-related escalations.
- Stay updated on changes in insurance policies, claim procedures, and AYUSH coverage guidelines.

5. Internal Hospital Coordination

- Work closely with doctors, billing, operations, and patient-care teams.
- Ensure timely and accurate documentation for all insurance cases.
- Maintain records of cashless approvals, reimbursement cases, pending claims, and claim settlements.
- Take ownership of each case and ensure proper follow-up until closure.

Mandatory Skills & Qualifications

- Minimum 3 years of relevant experience in hospital TPA operations, health insurance, or claims management.




- Practical knowledge of both cashless and reimbursement claim procedures.
- Strong understanding of health insurance policies, coverage, exclusions, and claim eligibility.
- Proven experience dealing directly with insurance companies and TPAs.
- Established professional contacts within insurance companies and TPA networks.
- Knowledge of pre-authorization, claim submission, documentation, query resolution, and settlement procedures.
- Strong communication, negotiation, coordination, and follow-up skills.
- Ability to independently manage multiple insurance cases.

Preferred Experience

- Knowledge of AYUSH insurance coverage and cashless treatment procedures.
- Experience handling claims related to Ayurveda and Panchakarma treatments.
- Familiarity with GIC-empanelled hospitals and insurance company empanelment procedures.

Personal Attributes

- Strong ownership and accountability.
- Patient-friendly and solution-oriented approach.
- Excellent interpersonal and relationship-management skills.
- Ability to handle challenging insurance cases professionally.
- Good team coordination and problem-solving abilities.

What We Expect

We are looking for someone who can independently manage the complete insurance lifecycle for our patients, from policy verification to claim closure.

The most important requirement is practical industry experience, established insurance company contacts, and the ability to get things done through effective coordination and follow-ups.

The candidate should ensure that eligible patients receive proper guidance and support, whether they opt for cashless treatment or reimbursement.

Pay: ₹25,000.00 - ₹30,000.00 per month

Work Location: In person

📌 TPA Executive (Sahibzada Ajit Singh Nagar)
🏢 Yukti Herbs - Multi Speciality Ayurveda & Panchakarma Hospital
📍 Sahibzada Ajit Singh Nagar