Tpa Executive

Role & responsibilities

• review and verify TPA deductions made from hospital bills.
  
• Cross-check claims, pre-authorizations, and payment details from TPAs to identify discrepancies.
  
• Reconcile payment and deduction reports with hospital billing and accounting records.
  
• Coordinate with insurance companies, TPAs, and internal departments to resolve deduction-related issues.
  
• Follow up on pending claims and deductions to expedite payments.
  
• Prepare regular reports on TPA deductions and highlight areas of concern or delay.
  
• Assist in audits and compliance checks related to TPA billing and deductions.
  
• Maintain accurate documentation and records of all deduction transactions.
  
• Provide support to the billing and finance teams regarding TPA-related queries.
  
• Stay updated on insurance policies, TPA guidelines, and regulatory requirements.
  

Preferred candidate profile

• experience in hospital billing, insurance claims, or TPA deduction management preferred.
  
• Understanding of healthcare insurance processes and TPA operations.
  
• Strong analytical and reconciliation skills.
  
• Good communication and coordination abilities.
  
• Proficiency in MS Office (Excel, Word) and hospital billing software.
  
• Attention to detail and accuracy.