TPA Executive
2 - 3 Years of Experience
Not disclosed 
Full TimeManipal Hospital, Gurugram
Gurugram, Haryana, India
Posted on 16-10-2024
1 Vacancy
Description
- Claims Processing: Efficiently process health insurance claims submitted by healthcare providers, ensuring accuracy and compliance with TPA and insurance company policies.
- Verification of Patient Information: Verify patient eligibility, coverage details, and benefits with insurance companies to facilitate smooth claims processing and prevent denials.
- Coordination with Healthcare Providers: Collaborate with hospitals, clinics, and healthcare providers to gather necessary documentation and resolve any issues related to claims and patient care.
- Communication with Insurers: Serve as a point of contact between patients, healthcare providers, and insurance companies, addressing queries and providing updates on claims status.
- Documentation Management: Maintain accurate and organized records of claims, correspondence, and related documentation, ensuring easy retrieval and compliance with regulatory requirements.
- Fraud Detection: Monitor claims for potential fraud or discrepancies, conducting investigations when necessary and escalating issues to the appropriate department.
- Customer Service: Provide excellent customer service to policyholders and healthcare providers, addressing concerns and guiding them through the claims process.
- Reporting and Analysis: Generate and analyze reports on claims processing activities, identifying trends and areas for improvement to enhance operational efficiency.
Category
Administration / Management
Key Skills
Attention to DetailAttentivenessNursingProblem solvingPositive AttitudeTeam Work
Aggregated job.
Learn more