Billing And TPA Executive

15,000 - 25,000 /month

Nishkarsh Hospital

Sector ZETA Gr Noida, Greater Noida

1 - 3 years Experience in Receptionist

Replies in 24hrs

5 Openings

Full Time

Skills Required

Computer Knowledge

Customer Handling

Handling Calls

Job Highlights

Graduate and above

All genders

10:00 AM - 08:00 PM | 6 days working

Job Description

Job Title: TPA Executive & Billing ExecutiveDepartment: Billing / Accounts / TPAReports To: Billing Manager / Hospital AdministratorJob Summary:The TPA (Third Party Administrator) & Billing Executive is responsible for coordinating with insurance companies, TPAs, and patients for cashless hospitalization and reimbursement claims. The role includes verifying insurance details, managing pre-authorization, billing, and ensuring timely settlement of claims while maintaining accurate documentation and compliance with hospital and insurance policies.Key Responsibilities:1. TPA Coordination:Handle all TPA-related activities, including pre-authorization, approval, and claim submission.Coordinate with TPA/insurance representatives for approval updates, query resolution, and final settlements.Maintain records of empaneled TPAs and regularly update the TPA master list.Monitor and follow up on pending or rejected claims.Prepare TPA-wise reports and maintain a database of all communications.2. Billing Operations:Prepare and verify patient bills (cash, credit, insurance, and corporate).Ensure all services and procedures are correctly charged in the billing system.Check billing accuracy and compliance with hospital tariff and policy.Coordinate with nursing, pharmacy, and diagnostics to ensure correct service entries.Handle discharge billing and coordinate with wards for final settlement.3. Documentation & Claim Management:Compile all documents required for claim submission (pre-auth, discharge summary, bills, investigation reports, etc.).Ensure timely submission of claims and maintain proper records of approvals and payments.Follow up with TPAs for shortfall queries, discrepancies, and settlement status.Assist in reconciliation of TPA accounts with finance/accounts departments.4. Customer & Interdepartmental Coordination:Communicate with patients and their relatives regarding insurance procedures, approvals, and billing details.Coordinate with doctors, nursing, and front office staff for insurance documentation and approvals.Provide support to patients for reimbursement claim documentation after discharge.5. Reporting & Compliance:Prepare daily/monthly TPA and billing reports for management.Ensure all billing and claim activities comply with hospital SOPs and insurance guidelines.Assist in audits and maintain confidentiality of patient and financial data.Key Skills & Competencies:Strong knowledge of hospital billing systems and insurance/TPA processes.Good communication and negotiation skills.Attention to detail and accuracy in documentation.Proficiency in hospital information systems (HIS) and MS Office.Ability to multitask and handle pressure in a fast-paced environment.Qualifications & Experience:Education: Graduate in Commerce, Healthcare Management, or a related field.Preferred: Diploma or certification in Medical Billing / Hospital Administration.Experience: 2–5 years in hospital billing, TPA coordination, or insurance claim management.Working Conditions:Hospital-based role (rotational or general shifts).May require weekend or holiday work based on hospital operations.

Other Details

It is a Full Time Receptionist job for candidates with 1 - 3 years of experience.

More about this Billing And TPA Executive job

What is the eligibility criteria to apply for this Billing And TPA Executive job?
Ans: The candidate should be Graduate and above and above with 1 - 3 years of experience of experience
How much salary can I expect for this job role?
Ans: You can expect a salary of ₹15000 - ₹25000 per month that depends on your interview. It's a Full Time job in Greater Noida.
How many working days are there for this Billing And TPA Executive job?
Ans: This Billing And TPA Executive job will have 6 working days.
Are there any charges applicable while applying or joining this Billing And TPA Executive job?
Ans: No, there is no fee applicable for applying this Billing And TPA Executive job and during the employment with the company, i.e., Nishkarsh Hospital.
Is it a work from home job?
Ans: No, it’s not a work from home job and can't be done online.
How many openings are there for this Billing And TPA Executive role?
Ans: There is an immediate opening of 5 Billing And TPA Executive at Nishkarsh Hospital
Who can apply for this job?
Ans: Both Male and Female candidates can apply for this Receptionist job.
What are the timings of this Billing And TPA Executive job?
Ans: This Billing And TPA Executive job has 10:00 AM - 08:00 PM timing.