Job Title: TPA Executive

Hospital: Devanika Hospital

Department: TPA & Insurance Desk / Cashless Services

Location: TUPUDANA, RANCHI, JHARKAHND

Job Type: Full time

Experience Required: Minimum 1 Year in TPA / Cashless Medical Claims Processing

Job Summary

Devanika Hospital is looking for a detail-oriented and experienced TPA Executive to join our team. The ideal candidate will be responsible for managing patient insurance claims, handling cashless approvals, liaising with various TPA/insurance companies, and facilitating smooth billing processes for our patients.

Key Responsibilities

1. Pre-Authorization & Cashless Approvals

- Collect and verify insurance documents, patient IDs, and coverage details upon admission.
- Fill out pre-authorization forms accurately and send them to respective TPA/Insurance portals promptly.
- Track initial approval status, answer queries raised by TPAs, and submit additional medical documents as requested.

2. Desk Coordination & Patient Assistance

- Serve as the primary point of contact between patients/families, hospital billing/medical teams, and TPA representatives.
- Guide patients through cashless coverage terms, co-payments, deductibles, and non-payable expenses.
- Obtain enhanced authorization approvals for extended stays or additional procedures as needed during hospitalization.

3. Claims Submission & Billing Settlement





- Coordinate with the medical records and billing departments to gather final discharge summaries, itemized bills, diagnostic reports, and pharmacy bills.
- Submit original claim files to TPA offices or upload them to web portals within required timelines.
- Monitor claim processing status, resolve rejections/short-payments, and follow up on pending payments from insurance companies.

4. Record Maintenance & Compliance

- Maintain accurate daily registers of cashless admissions, approvals, denials, and pending claims.
- Ensure complete compliance with IRDAI guidelines, NABH standards, and individual TPA policies.

Required Skills & Qualifications

- Experience: Minimum 1 year of hands-on experience in TPA desk operations within a hospital environment.
- Familiarity with major TPA web portals (e.g., Star Health, MDIndia, Medi Assist, Vidal, Heritage, Paramount, etc.).
- Understanding of medical terminology, billing codes, and insurance claim processes.
- Strong written and verbal communication skills.
- Proficiency in MS Office (Excel, Word) and Hospital Information Systems (HIS).
- Good problem-solving skills and ability to manage patient concerns with patience and empathy.

Interested candidates can send their updated resume to [[email protected]] with the subject line "Application for TPA Executive - [Candidate Name]"

Pay: ₹15,000.00 - ₹24,000.00 per month

Work Location: In person

📌 TPA (India)
🏢 Devanika Hospital
📍 India