01Responsibilities
Responsible for TPA / Insurance Empanelment & renewals of contracts. Responsible for periodical tariff revision & price negotiation with private & GIPSA insurance companies. Responsible for timely recoveries of TPA Credit sales. (Collection & Deduction Recovery)Liaoning with TPAs & Insurer key persons and relationship building. Responsible for Rejection & Deduction follow ups. Responsible for account reconciliation with internal & external customers. Regular record updating of Insurance & Deduction TrackerPeriodic review of individual and departmental performance. Defining the organizational goals, strategies, setting of internal monthly targets for collection & deductions. Monitor, administer & training of the centralize team. Regular visits & meeting with internal customers of the group such as TPA Desk, Finance & Accounts, Front Office, and Bill Dispatch Departments; ensuring smooth functioning of the TPA Process.Performing troubleshooting during cashless approvals and pre & post-discharge of the patients for all unitsEnsuring groups timely dispatch of credit invoices for payment recoveriesReconciling accounts with all TPAs, Insurance Companies, and internal Finance TeamsDirecting on-account (NEFT) settlement for ensuring timely settlement of NEFT payments, creating departmental MIS, reports, and presentations pertaining to TPA revenue, debtors aging, collection, deduction, old payment & NEFT (on-account) settlement for periodic review of team with higher managementFollowing-up for deduction and rejection of the TPA claims; reviewing & analysing Debtor Ageing and Daily Collection ReportsMonitoring day to day work of team on receivable software i.e., Eprapti. To define and set the centralized TPA process. Motivating the team and responsible for high team morale.
Experience & Qualifications:
Graduate, preferably with an MBA in Marketing or a Diploma in Marketing.Preferably with 6 to 10 years of experience in healthcare of handling TPA / Insurance channel.Strong Interpersonal skills and conflict resolution ability Extremely strong Networking Skills Good Organization and Planning Skills Strong Relationship Management Skills Strong focus on performance and Service Excellence .
