<ul><li>Guide patients and their families regarding the insurance claim process, required documentation, and eligibility criteria.</li><li>Verify and collect necessary documents from patients for insurance claims.</li><li>Ensure accurate and complete submission of insurance pre-authorization and reimbursement requests.</li><li>Liaise with TPAs and insurance companies to obtain approvals and pre-authorizations for medical treatments and procedures.</li><li>Follow up on pending approvals and escalate issues to ensure timely resolution.</li><li>Coordinate with insurance companies for claim settlements and reimbursement processing.</li><li>Work closely with the billing department to ensure alignment of medical expenses with insurance coverage.</li><li>Review patient bills and ensure correct documentation for cashless claims or reimbursements.</li><li>Address discrepancies in claim processing and resolve disputes between patients, hospital management, and TPAs.</li></ul>

TPA Executive