Tpa Manager

Role & responsibilities:

• In-charge of TPA Department for patient care services
• Maintaining TAT for Claim processing (pre auth to final submission)
• Scrutiny of documents and coordination between patient and TPA/insurance co.
• TPA/Insurance query reply within TAT
• Review of disallowance and focus on reduction
• Interact with patients for any billing related matters or administrative matters.
• Handle queries related to government empanelments such as MJPJAY, PMJAY, CGHS, ESIC, and manage the empanelment process for new corporate and TPAs.
• Monitor all corporate and TPA accounts, including managing bill recovery and resolving billing issues.

Preferred candidate profile:

• Qualifications: Master's in Health Administration( MHA) , MBA
• Experience: 2 - 5 years of Experience as TPA Manager in healthcare industry