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TPA Manager
Kangra, Himachal Pradesh
₹40,000 - ₹70,000 a month
Full-time

Job details

₹40,000 - ₹70,000 a month
Full-time
Kangra, Himachal Pradesh

Full job description

Contact-8756570851

  • Manage end-to-end TPA and insurance desk operations for the hospital.
  • Ensure timely processing of pre-authorizations, approvals, and discharge cases.
  • Coordinate with TPAs, insurance companies, patients, doctors, and internal departments.
  • Monitor claim submission, documentation, billing, and settlement processes.
  • Ensure accurate and timely submission of insurance/TPA claims.
  • Follow up on pending approvals, queries, deductions, and outstanding claims.
  • Resolve claim-related discrepancies and coordinate for timely closure.
  • Ensure compliance with TPA, insurance, hospital, and regulatory guidelines.
  • Monitor claim rejection, denial, and deduction trends and take corrective action.
  • Maintain accurate MIS and prepare regular reports on TPA performance and collections.
  • Track outstanding amounts and coordinate with the billing/accounts team for recovery.
  • Lead and guide the TPA desk team to achieve operational and financial targets.
  • Ensure proper documentation and maintain records for audits and inspections.
  • Develop strong working relationships with key TPA and insurance representatives.
  • Drive process improvements to enhance patient experience, turnaround time, and revenue realization.

Pay: ₹40,000.00 - ₹70,000.00 per month

Work Location: In person

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