<ul><li>Lead and manage the entire TPA department to ensure efficient handling of cashless and reimbursement claims.</li><li>Liaise with multiple insurance companies and TPAs for approvals, payments, and issue resolution.</li><li>Supervise the processing of pre-authorizations, final bill approvals, and discharge documentation.</li><li>Ensure timely submission of claims and minimize rejections or delays in payments.</li><li>Maintain compliance with IRDA regulations, NABH standards, and hospital protocols.</li><li>Analyze claim trends, pending dues, and coordinate with the finance team for reconciliations.</li><li>Train and mentor the TPA team on process updates, software usage, and communication skills.</li><li>Resolve escalated issues from patients, TPAs, or internal departments with professionalism.</li><li>Prepare and present MIS reports on claims status, revenue impact, and process efficiency.</li></ul>

TPA Manager