Hospital Provider Partnership

Overview: Coordinates daily claim operations between network hospitals and the internal TPA/insurance claims team for seamless cashless approvals and processing.
Key Responsibilities:

• Hospital Coordination: Manage cashless approvals, pre-authorizations, and daily hospital desk queries.
• Document Verification: Verify medical records, bills, and discharge summaries for accuracy before processing.
• Query Resolution: Resolve claim discrepancies between medical adjudication teams and hospital staff to minimize delays.
• Process Tracking: Monitor claims lifecycle to ensure strict adherence to turnaround times (TAT).

Key Requirements:

• Bachelors degree.
• 1 year experience in hospital desk ops, claims, or provider coordination (TPA/Insurance).
• Knowledge of health insurance workflows, medical terms, and MS Excel / Google Sheets.
• Strong written English and spoken proficiency in Hindi, English, and Gujarati.

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