TPA Executive

JOB RESPONSIBILITY

• Need to reach Hospital on Time and cross check the cleanliness of Cashless & TPA room, need to check proper working condition of internet, PC, Printers, Telephone Lines.
• Should have an updated list of all TPA & Govt PSU on panel with updated MOU & Rate list as per agreed tariff, Email ID with Contact Number of costumer care and TPA Coordinator.
• Should have proper knowledge of all the documents required for cashless approval, Preauthorization form, claim form and process like RSBY, BSBY, ECSH, CGHS.
• Should handle entire billing part and documentation.
• Should fill the accurate form , necessary document required and package opted & should send file to concerned TPA for approval , once the approval received should intimate reception staff to call and inform patient same and surgery appointment to be given accordingly.
• Once the surgery is done should fill the claim form along with discharge summary & bill and should have scan copy of all & should courier the claim form after verification and should keep record of POD number.
• Should maintain an excel tracker with all necessary detail and POD number & payment status against each case. Should know the payment cycle of each TPA, ECSH Govt PSU, RSBY , BSBY and take follow-up once the cycle date exceeds.
• Will be responsible to avail approval within 24 hours of request and dispatch the claim file within 48 hours of billing , also if there is any query raised to be consulted to appropriate doctor and replied properly , all relevant query should be replied within 12 hours of query raised.
• Monthly report should be made patient wise tracker with POD & Payment status & pending payment to be informed to central team.
• All data should be scanned & saved soft copy & hard copy and should be provided when ever asked from central team.
• Should report daily number of cashless surgery done at center on forum.
• For any query should consult with IT, A/Cs & Cashless department in coordination with operations Manager.
• Full responsibility from processing for approval till final payment received is liable on cashless department.
• Weekly should check Govt website for any new or update on notification.
• Need to cross verify all the bills and get it cross verified from the Operations Manager and get it signed before submission.
• Before leaving from Hospital need to submit the day report and next day schedule to Operation Manager.

Pay

₹20,000.00 - ₹35,000.00 per month

Benefits

Health insurance

Work Location

In person