TPA Coordinator

 JOB DESCRIPTION - TPA Coordinator

1.     To co-ordinate with cashless patients, TPAs / Insurance companies and corporate for smooth functioning of cashless treatment provided to the patient.

2.     To check the details of Insurance patients admissions who are admitted after office hours - late evening, night & early morning. To coordinate with cashier, floor executive and duty admin supervisor in this regard.

3.     To interact with the patients / their attenders regarding their ailments – advised for admission. 

4.     To send the pre-authorization forms to the concerned TPAs and to follow-up till receipt of initial approval.

5.      To send appropriate reply to the queries (if any) raised by Insurance people.

6.     To submit the discharge documents for approval (enhancements) for the discharge declared patients and follow till receipt of receipt of approval.

7.     Handling problems related to authorization, rejection of claim and difficult issues or queries etc.

8.     Resolving patient complaints regarding insurance matters.

9.     To prepare bill the insurance patients after the discharge and co-ordinate with the billing staff in bill preparation and submission.

10. To coordinate the billing staff in proper filling of process documents and acknowledgements.