Tpa Billing Executive - Amritsar, Punjab, India - Cancer Centers of America
Description
Any other work assigned by Corporate Finance Team / Unit Head, from time to timeClaims Processing:
Oversee the end-to-end process of insurance claims submission and follow-up. Ensure accuracy and completeness of claim documentation before submission.
Coordinate with medical billing and coding teams to resolve claim discrepancies.
Third-Party Administrator (TPA)
Management:
Develop and maintain relationships with TPAs to streamline communication and enhance collaboration.
Negotiate and review service agreements with TPAs to ensure favorable terms for the hospital. Monitor TPA performance and address any issues promptly.
Verification and Authorization:
Verify patient insurance coverage and obtain necessary authorizations for procedures and treatments.
Collaborate with medical staff and insurance companies to address authorization-related issues.
Reimbursement and Revenue Cycle
Management:
Monitor and analyze reimbursement trends to identify opportunities for revenue enhancement.
Implement strategies to reduce claim denials and improve reimbursement rates.
Claims Denial
Management:
Investigate and analyze reasons for claims denials and implement corrective actions.
Collaborate with the Accounts team to appeal denied claims and minimize financial impact.
Reporting and Analytics:
Generate regular reports on insurance and TPA performance metrics.
Provide insights and recommendations based on data analysis to improve processes and financial outcomes.
Regulatory Compliance:
Stay informed about changes in healthcare insurance regulations and ensure the hospital's compliance.
Implement and update policies and procedures to align with regulatory requirements.
Customer Service:
Serve as a point of contact for insurance companies, TPAs, and internal and external customers regarding insurance-related inquiries.
Address patient concerns related to insurance and claims processing.
Job Types:
Full-time, Permanent
Pay:
₹15, ₹30,000.00 per month
Benefits:
- Paid sick time
- Provident Fund
Schedule:
- Rotational shift
Education:
- Bachelor's (preferred)
Experience:
- Third-Party Administrator (TPA)
Management: 1 year (preferred)
Work Location:
In person
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