TPA EXECUTIVE Jobs Opening in Platinum Hospital Pvt. at Thane, Mumbai
Job Description
Process cashless and reimbursement claims with accurate verification of policy coverage, treatment details, and medical documentation.
Manage pre-authorization requests, obtain approvals, and respond to insurer/TPA queries within defined timelines.
Coordinate with insurance companies, TPAs, medical records (MRD), billing, and clinical teams to ensure seamless claim processing.
Validate ICD/CPT coding accuracy, billing breakups, discharge summaries, and treatment justifications as per insurance standards.
Track claim status through TPA portals and hospital HIS, update records, and escalate delays or discrepancies.
Handle denials, short settlements, and claim audits, ensuring compliance with hospital policies and insurance guidelines.
Assist patients with eligibility checks, approval updates, claim requirements, and related insurance queries.
Maintain documentation for internal audits, insurance audits, and compliance checks while ensuring data accuracy and confidentiality.
More information about this TPA EXECUTIVE Job
Please go through the below FAQs to get all answers related to the given TPA EXECUTIVE job
- What are the job requirements to apply for this TPA EXECUTIVE job position?
- Ans: A candidate must have a minimum of 0 to 3 year experience as an TPA EXECUTIVE
- What is the qualification for this job?
- Ans: The candidate can be a Graduate from any of the following: B.Com
- What is the hiring Process of this job?
- Ans: The hiring process all depends on the company. Normally for an entry level, hiring the candidate has to go for Aptitude, GD (If they look for communication),Technical test and face to face interviews.
- This TPA EXECUTIVE is a work from home job?
- Ans: No ,its not a Work from Home Job.
- How many job vacancies are opening for the TPA EXECUTIVE position?
- Ans: There are immediate 1 job openings for TPA EXECUTIVE in our Organisation.