Job Description

1. Claims Management:

• Assist in the management of the claims process: Oversee the submission, tracking, and follow-up of insurance claims to ensure timely processing and reimbursement.
• Coordinate with insurance providers: Act as a liaison between the hospital and insurance companies to resolve claim issues and address inquiries.
• Verify claims accuracy: Review claims for completeness and accuracy, ensuring all necessary documentation is provided.

2. Patient Support:

• Assist patients with insurance-related queries: Provide support to patients regarding their insurance coverage, claim status, and benefit information.
• Resolve patient complaints: Address and resolve patient concerns related to insurance claims or billing issues in a timely and professional manner.

3. Administrative Duties:

• Maintain records: Ensure that all TPA-related records and documentation are accurately maintained and updated.
• Prepare reports: Assist in generating reports on claims status, reimbursements, and other relevant metrics for internal review and decision-making.
• Document management: Ensure proper filing and archiving of all TPA-related documents and correspondence.

4. Compliance and Regulations:

• Ensure compliance: Stay up-to-date with insurance regulations, hospital policies, and industry standards to ensure all activities are compliant.
• Assist in audits: Support internal and external audits by providing necessary documentation and information related to TPA services.

5. Process Improvement:

• Identify inefficiencies: Evaluate existing processes for potential improvements and suggest enhancements to streamline operations.
• Implement best practices: Assist in developing and implementing best practices for TPA processes and procedures.

6. Team Collaboration:

• Work with internal teams: Collaborate with medical, administrative, and financial departments to ensure smooth operations and address any TPA-related issues.
• Train staff: Provide training and support to hospital staff on TPA processes, insurance claims, and patient interactions as needed.

Job Type: Full-time

Pay: ?15,000.00 - ?22,000.00 per month

Benefits:

• Cell phone reimbursement
• Health insurance
• Paid sick time
• Provident Fund

Schedule:

• Day shift
• Fixed shift
• Rotational shift

Supplemental pay types:

• Overtime pay

Experience:

• total work: 2 years (Preferred)

Work Location: In person