Job Description

: TPA Coordinator
Position: TPA Coordinator

Job Overview

The TPA (Third-Party Administrator) Coordinator plays a critical role in managing and coordinating insurance-related processes between patients, hospitals, and TPAs. They ensure timely approvals, documentation, and settlements to enhance patient satisfaction and streamline operations.

Key Responsibilities

• Coordination with TPAs and Insurance Companies:
• Serve as the primary point of contact for TPAs and insurance agencies.
• Facilitate pre-authorization approvals for planned and emergency procedures.
• Patient Interaction:
• Assist patients and their families in understanding the insurance process.
• Collect and verify insurance documents, policy details, and eligibility.
• Documentation Management:
• Maintain accurate records of pre-authorization, claims, and settlements.
• Ensure submission of claims with all required supporting documents.
• Claim Processing and Follow-ups:
• Monitor and track the progress of claims submitted.
• Liaise with TPAs for query resolution, approvals, and claim settlements.
• Compliance and Updates:
• Stay updated with insurance policies, TPA procedures, and regulatory guidelines.
• Ensure compliance with hospital protocols and insurance regulations.
• Collaboration with Internal Teams:
• Work closely with billing, admissions, and discharge teams to ensure smooth workflow.
• Support the finance team in reconciling TPA payments and pending dues.

Skills and Competencies

• Strong communication and interpersonal skills.
• Attention to detail and accuracy in documentation.
• Proficiency in using hospital management software and MS Office.
• Ability to handle stressful situations with patience and professionalism.
• Problem-solving and time management skills.

Qualifications and Experience

• Bachelor's degree in any field (Healthcare Management preferred).
• 1-3 years of experience in TPA coordination or insurance-related roles in healthcare.
• Familiarity with medical terminologies and hospital operations is an advantage.

Join our team and contribute to delivering a seamless healthcare experience for our patients.

Job Types: Full-time, Permanent

Pay: ?10,000.00 - ?16,000.00 per month

Experience:

• Hospital: 1 year (Required)

Location:

• Kalyani, West Bengal (Preferred)

Work Location: In person