Billing And TPA Executive

### **Job Title: TPA Executive (Ayushman Bharat / PMJAY)**

**Company:** Medsure Claim Solution

**Salary:** ₹10,000 – ₹20,000 per month

**Experience:** 1–2 years preferred

**Qualification:** Minimum Above 12th (Healthcare/Paramedical background preferred)

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### **Job Overview:**

We are looking for a dedicated and detail-oriented **TPA Executive** to manage end-to-end processes related to **Ayushman Bharat (PMJAY)** and other insurance/TPA schemes within the hospital. The role involves patient beneficiary verification, claim processing, and coordination with hospital departments to ensure smooth and timely claim settlements.

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### **Key Responsibilities:**

• Verify patient eligibility under **Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY)** using BIS portal

• Handle **beneficiary card verification and registration** on the portal

• Process **pre-authorization (Preauth)** requests accurately and within timelines

• Manage **enhancement requests** based on treatment progress

• Coordinate for **final discharge entry and claim submission**

• Ensure proper **collection, scanning, and uploading of claim documents**

• Maintain complete and error-free **documentation as per TPA guidelines**

• Follow up with TPA/insurance companies for **claim approvals and settlements**

• Ensure compliance with **scheme guidelines and hospital policies**

• Maintain daily records and prepare reports related to claim status

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### **Job Requirements:**

• Minimum qualification: Above 12th (Graduate preferred)

• 1–2 years of experience in **TPA / Ayushman Bharat / Hospital Billing**

• Good knowledge of **PMJAY portal (BIS & TMS)**

• Basic computer skills (MS Excel, data entry, scanning)

• Strong communication and coordination skills

• Ability to work in a fast-paced hospital environment

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### **Preferred Skills:**

• Experience in hospital front desk / billing / insurance desk

• Knowledge of medical terminology and hospital workflow

• Attention to detail and accuracy in documentation

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### **What We Offer:**

• Fixed salary with growth opportunities

• Hands-on experience in government healthcare schemes

• Supportive and professional work environment

Contact us - 6394197916

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