<ul><li>Oversee all TPA-related operations including pre-authorizations, claims processing, and approvals.</li><li>Coordinate with insurance companies, TPAs, and hospital billing departments for smooth patient admission and discharge.</li><li>Ensure timely and accurate submission of necessary documents for cashless and reimbursement claims.</li><li>Monitor the status of claims and follow up on pending approvals or payments.</li><li>Verify patient insurance details, policy coverage, and eligibility before processing requests.</li><li>Resolve discrepancies, rejections, and queries from TPAs and patients efficiently.</li><li>Maintain proper documentation and records of TPA interactions and transactions.</li><li>Train and guide TPA coordinators and support staff for adherence to protocols.</li><li>Liaise with consultants and treating teams to obtain medical justifications for claims.</li></ul>

TPA Incharge