TPA Coordinator

Job Description :

We are seeking a dedicated and detail-oriented TPA (Third Party Administrator) Coordinator to join our team. The TPA Coordinator will be responsible for managing all activities related to TPA operations, including coordination with insurance companies, claim settlement, documentation, and ensuring smooth cashless hospitalization processes for patients.

Key Responsibilities :

• Coordinate with TPAs and insurance companies for cashless hospitalization approvals and claims settlement.
• Verify and process pre-authorization requests and insurance documents.
• Maintain accurate records of insurance approvals, rejections, and pending cases.
• Ensure compliance with all TPA guidelines and hospital policies.
• Handle queries from patients and their families regarding insurance coverage and documentation.
• Follow up with TPAs / insurance companies for timely claim settlements.
• Prepare and submit required MIS reports related to TPA activities.
• Work closely with hospital billing and finance teams for reconciliation of claims.

Requirements :

Benefits :

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Skills Required

Word, Excel, Ms Office