Department: Billing / Finance
Location: kompally
Reports to: Billing Manager / Finance Head / TPA Manager
Employment Type: Full-time
The Billing and TPA Executive is responsible for managing patient billing processes, coordinating with Third Party Administrators (TPAs), and ensuring timely processing of insurance claims and payments. The role requires strong attention to detail, knowledge of medical billing codes, and experience handling TPA documentation and communication.
Generate accurate patient bills based on medical services provided.
Verify treatment details and ensure appropriate application of rates.
Handle cash, card, and digital payments and issue receipts.
Monitor outstanding balances and follow up on pending payments.
Maintain and update billing records in the hospital management system (HMS).
Liaise with TPA/insurance companies for pre-authorization and claim approvals.
Submit necessary documentation (discharge summaries, bills, reports, etc.) for claims.
Track claim status and follow up for timely payments.
Resolve TPA queries, discrepancies, and rejections in a timely manner.
Maintain updated records of empaneled TPAs and their terms.
Ensure all billing and claim processes comply with hospital policies and insurance regulations.
Maintain confidentiality of patient and financial information.
Generate regular MIS reports for management review.
Assist in audits and provide documentation as required.
Bachelor’s degree in Commerce, Business Administration, or related field.
1–3 years of experience in hospital billing and TPA handling.
Knowledge of hospital management systems (HMS), billing codes (ICD/CPT), and insurance claim procedures.
Strong communication and coordination skills.
Attention to detail and accuracy in billing.
Familiarity with TPA processes and documentation.
Proficient in MS Office (especially Excel).
Ability to handle high-pressure situations and multitask.
Experience working with large hospital chains.
Certification in medical billing or hospital administration.