01Key Responsibilities
Manage day-to-day TPA operations, including claim submissions and follow-ups.
Coordinate with insurance companies to ensure timely approvals and reimbursements.
Review and process claim documents and ensure compliance with hospital policies and insurance guidelines.
Address and resolve any disputes or issues related to claims in a skilled manner.
Maintain accurate records of all transactions and communications with TPAs and insurance providers.
Train and mentor junior staff in TPA operations and processes.
Monitor and report on TPA performance metrics to senior management.
Collaborate with various departments within the hospital to enhance the overall patient experience.
Participate in audits and ensure adherence to regulatory requirements.
Skills and Tools Required:
Solid understanding of healthcare insurance processes and TPA operations.
Excellent communication and interpersonal skills.
Analytical skills for processing claims and resolving disputes.
Proficient in MS Office Suite (Word, Excel, PowerPoint).
Familiarity with hospital management software and claim processing tools.
Ability to work collaboratively in a fast-paced workplace.
Strong attention to detail and organizational skills.
Experience in a healthcare setting, particularly in insurance or TPA roles, is preferred.
Join Manipal Hospitals and be a vital part of our commitment to providing quality healthcare through effective management of TPA operations. .
