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

TPA