Third Party Administrator (TPA)

Position Details Role

- Third Party Administrator (TPA)

- Office Locations: Paschim Vihar, Delhi

- Duty Timings: 9:00 AM - 6:00 PM

- Joining: Immediate joiners preferred

We are looking for a detail-oriented TPA Executive to manage cashless insurance and reimbursement processes, coordinate with Third Party Administrators (TPAs), insurance companies, and the CGHS desk, and ensure timely claim processing while delivering a seamless patient experience.

Key Responsibilities

- Process cashless hospitalization and reimbursement claims.

- Coordinate with TPAs, insurance companies, and CGHS authorities for pre-authorizations and claim approvals.

- Verify patient insurance eligibility, policy coverage, and required documentation. Prepare and submit pre-authorization requests, claim forms, and supporting medical documents.

- Follow up on pending approvals, claim settlements, and reimbursement cases. Coordinate with doctors, nursing, billing, medical records, and front office teams for claim related documentation.





- Ensure accurate documentation as per TPA, CGHS, and NABH guidelines. Resolve claim queries, discrepancies, deductions, and rejections within the stipulated timelines.

- Maintain records of claims, approvals, settlements, and pending cases.

- Ensure compliance with hospital policies, NABH standards, and insurance regulations.

- Assist patients in understanding insurance procedures and provide timely updates on claim status.

Requirements Experience:

- 2–5 years of relevant experience in TPA operations, medical insurance claims, or hospital billing.

- Experience in handling cashless hospitalization and reimbursement claims is mandatory.

- Knowledge of CGHS claim processing and NABH documentation standards will be preferred.

- Proficiency in MS Office and Hospital Information Systems (HIS).

Pay: ₹10,000.00 - ₹40,000.00 per month

Work Location: In person

📌 Third Party Administrator (TPA) (Paschim Vihar)
🏢 Sat Kartar Life
📍 Paschim Vihar