TPA Coordinator

Job Description

CCA Hospital is seeking a highly experienced TPA (Third Party Administrator) Coordinator to join our team in Amritsar. The TPA Coordinator will be responsible for managing and coordinating with various insurance companies and third-party administrators to ensure smooth and efficient handling of insurance claims and patient billing processes.

Qualification

• Graduation/Post Graduation in any specialization.

• 8-12 years of experience in the health industry, specifically in managing insurance claims and working with TPAs.

• Strong understanding of health insurance policies, billing procedures, and claims processing.

• Excellent communication and interpersonal skills.

• Detail-oriented with strong organizational and problem-solving abilities.

• Proficiency in using healthcare information systems and billing software.

Key Responsibilities

• Coordinate with insurance companies and third-party administrators (TPAs) for processing patient claims.

• Ensure accurate and timely submission of insurance claims and necessary documentation.

• Review and verify patient insurance coverage and benefits.

• Handle inquiries and resolve issues related to insurance claims and billing.

• Maintain and update patient records with insurance information and claim status.

• Work closely with the finance and billing departments to ensure alignment and accuracy in claims processing.

• Provide support and guidance to patients regarding their insurance claims and benefits.

• Stay updated with changes in insurance policies and regulations affecting claims processing.

• Generate reports and analyze data related to insurance claims and reimbursement.

Skills and Competencies:

• In-depth knowledge of insurance claims processing and TPA coordination.

• Strong analytical and reporting skills.

• Ability to manage multiple tasks and prioritize effectively.

• Strong negotiation and conflict resolution skills.

• Ability to work collaboratively with cross-functional teams.

• Commitment to maintaining patient confidentiality and data security.