TPA Coordinator WadiaHospital (Children)

1.0 - 4.0 years

1 - 4 Lacs

Mumbai

Work from Office

The selected candidate willbe responsible for managing the approval and rejection processes for cashlessclaims under TPA and MJPJAY schemes. This will involve close coordination withhospital doctors, wards, the billing team, and insurance companies. Key Responsibilities: Handle approval and rejection of cases within the TPA department. Coordinate with hospital doctors and wards to ensure the availability of cashless facilities for patients. Manage pre-authorizations, patient admissions, and discharges, especially in the absence of the respective TPA/MJPJAY team member. Collaborate with the in-house ward, ICU, IPCU, and billing team to ensure final cashless approval for patients. Resolve issues related to cashless claims with TPA/MJPJAY authorities. Coordinate with TPA and insurance companies for approvals, rejections, or queries related to cashless cases. Prepare daily MIS reports for cashless cases. Be well-versed with TPA and MJPJAY portals for smooth processing. Settle cashless cases on the HMIS portal. Prepare refund sheets for cashless deposit refunds. Qualifications

Posted 1 day ago

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Tpa Coordinator Jeena Sikho Lifecare

1.0 - 6.0 years

1 - 3 Lacs

Prayagraj, Thane, Patna

Work from Office

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Astha Saklani 7087994355 HRD

Posted 4 days ago

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