Tpa Coordinator

Company: Jeena Sikho Lifecare Ltd.
Job Title: TPA / Office Coordinator
Department: TPA / Operations
Location: Hospital Branch
Employment Type: Full-Time
Budget: 25K- 30K per month
Working Days: 6 Days a Week

Job Overview

Jeena Sikho Lifecare Ltd. is looking for an experienced TPA Panel Head to manage and coordinate all TPA (Third Party Administrator) and government healthcare panels, including CGHS, ECHS, CAPF, ESIC, and other corporate or insurance panels. The candidate will be responsible for empanelment, documentation, claim coordination, billing support, and maintaining strong relationships with TPAs and government authorities.

Key Responsibilities

• Manage all TPA and government healthcare panels, including CGHS, ECHS, CAPF, ESIC, and other corporate/insurance panels.
• Handle new empanelment, renewals, and documentation for government and private panels.
• Coordinate with insurance companies, TPAs, and government authorities for approvals and claim processing.
• Ensure timely submission of claim documents and follow up for settlements.
• Resolve claim rejections, deductions, and pending payment issues.
• Coordinate with billing, accounts, medical records, and hospital departments for smooth claim processing.
• Maintain complete records of empanelments, claims, and payment status.
• Prepare daily, weekly, and monthly MIS reports related to TPA operations.
• Ensure compliance with TPA, insurance, and government guidelines.
• Build and maintain strong relationships with TPA officials, corporate clients, and government departments.
• Monitor outstanding payments and coordinate with the accounts team for reconciliation.

Educational Qualification

• Graduate in any discipline.

Experience

• 2-4 years of experience in TPA Operations, Hospital Billing, Insurance Claims, or Healthcare Panel Management.
• Hands-on experience in handling CGHS, ECHS, CAPF, ESIC, and other government or insurance panels is mandatory.

Required Skills

• Strong knowledge of TPA processes and insurance claim management.
• Experience in government healthcare panels (CGHS, ECHS, CAPF, ESIC).
• Billing and reimbursement process knowledge.
• Documentation and compliance management.
• MS Excel, Word, and Hospital Information System (HIS).
• Excellent communication and negotiation skills.
• Strong follow-up and coordination abilities.
• Problem-solving and analytical skills.

Key Competencies

• TPA & Insurance Management
• Government Panel Coordination
• Claim Processing
• Billing & Reconciliation
• Documentation & Compliance
• Vendor & Stakeholder Management
• MIS Reporting
• Communication & Negotiation

Salary

25,00030,000 per month

Benefits

• PF & ESIC (as applicable)
• Paid Leave
• Career Growth Opportunities
• Supportive Work Environment
• Other benefits as per company policy