<ul><li>Handle cashless and reimbursement claims for insured patients through Third-Party Administrators (TPA).</li><li>Verify insurance policies, eligibility, and coverage limits before processing claims.</li><li>Ensure accurate documentation of patient details, treatment, and medical expenses for claim approval.</li><li>Generate and submit pre-authorization requests for procedures, surgeries, and inpatient admissions.</li><li>Liaise with insurance providers and TPA representatives for approval and claim settlements.</li><li>Follow up on pending approvals, rejected claims, and resubmissions as required.</li><li>Ensure compliance with insurance guidelines and government healthcare policies.Maintain patient records, treatment history, and insurance claim status.</li><li>Process invoices, charge sheets, and final billing for TPA patients.</li><li>Ensure correct application of package rates, discounts, and exclusions as per insurance agreements.</li></ul>

TPA Billing Specialist