Junior Officer/ Officer / Senior Officer – Customer Care - TPA

Junior Officer/ Officer / Senior Officer – Customer Care - TPA
Job No.
SS 03
Department
Support Staff and Tech
Location
Mumbai
Work Experience
1 - 5 Years
Qualification
Any graduate
Description
  • To guide the patients and attendants regarding the TPA services provided by the hospital
  • To be ready to help the patient
  • Ensure first experience to be a great experience for the patients
  • To counsel the patients/attendants regarding the TPA formalities and consents
  • To help the patients/attendants fill the pre-authorization forms
  • To fill the estimate of the treatment of the pre-authorization forms
  • To send the pre-authorization forms to the respective TPAs/insurance companies
  • To coordinate with the TPAs/insurance companies for the approval
  • To update the patient/relatives regarding their claim status
  • To enter the approval amount in the system on EHIS
  • To send the interim bills to the TPA/insurance companies for enhancement
  • To arrange for the documents required by the TPA/insurance companies for the approval
  • Filing & Updation of the TPA files
  • To answer patient queries regarding cashless & reimbursement claims
  • To collect all the documents related to claim submission & maintaining the file
  • To be a part of the Quality Improvement Initiative & Protocols of the organization.