Walk-in || TPA Executive - Max Patparganj

Role & responsibilities

• To be responsible for maintaining TPA Processing of cashless and all post discharge health insurance claims. • To be responsible to maintain overall TAT entry to exit. • TPA query reply and preauthorisation follow up with insurance company / tpa. • Medical scrutiny and medical opinion for health insurance claims. • Efficient in claim adjudication and claim processing. • Maintaining and ensuring Standard Operating Procedures and protocols. • To be responsible for keeping record for all correspondence done for TPA. • Post discharge reconciliation for utilization of claims. • Timely reply to internal TPA complaint portal. • TPA discharge follow up and closure. • Mmaintenance of departmental records as per the NABH requirement. • Effective utilization of hospital information system, MIS generation of TPA patients. • To display proactive cooperation and contribute to cordial inter and intra team relations, solution orientation and team solidarity. Should be cost effective. • To participate in training programs to maintain and update your professional knowledge. • To achieve high levels of customer satisfaction at each interaction. • Any task assigned to you by your HOD from time to time.

Preferred candidate profile

• Min 2 Years of relevant experience in TPA only
• Hospital TPA experience preferred
• Must be Graduate