TPA

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TPA

work outline icon0 - 5 Years of Experiencerupess outline iconNot disclosed time outline iconFull Time

Silver Streak Multi Speciality Hospital, Gurugram

time outline iconGurugram, Haryana, India

Posted on 18-11-2024

178 Views

1 Vacancy

Description

  • Coordinate between healthcare providers, insurance companies, and policyholders to manage insurance claims efficiently.
  • Verify the authenticity of insurance policies and coverage details to ensure claims eligibility.
  • Assist patients with insurance-related inquiries, explaining coverage, claim procedures, and documentation requirements.
  • Process and review medical claims, ensuring accuracy and compliance with policy terms and conditions.
  • Liaise with healthcare providers to ensure the timely submission of claims, medical reports, and necessary documents.
  • Provide support for pre-authorizations, ensuring approval from insurance companies for treatments and procedures.
  • Resolve claim disputes and follow up with both insurers and policyholders to expedite processing.
  • Maintain accurate records of claims, approvals, and communications for auditing and reporting purposes.
  • Collaborate with healthcare providers to ensure the proper billing of services in accordance with insurance contracts.
  • Stay updated with changes in insurance policies, healthcare regulations, and billing practices to ensure smooth claim processing.

Category

Administration / Management

Key Skills

Communication SkillsProblem solvingAttention to DetailPositive Attitude

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