Role Overview

The Candidate will be responsible for overseeing and monitoring end-to-end health insurance / TPA process & credit sales & Collection channel across Max Healthcare.

Key Roles and Responsibilities:

Responsible for TPA / Insurance Empanelment & renewals of contracts.
Responsible for periodical tariff revision & price negotiation with private & GIPSA insurance companies.
Responsible for timely recoveries of TPA Credit sales. (Collection & Deduction Recovery)
Liaoning with TPAs & Insurer key persons and relationship building.
Responsible for Rejection & Deduction follow ups.
Responsible for account reconciliation with internal & external customers.
Regular record updating of Insurance & Deduction Tracker
Periodic review of individual and departmental performance.
Defining the organizational goals, strategies, setting of internal monthly targets for collection & deductions.
Monitor, administer & training of the centralize team.
Regular visits & meeting with internal customers of the group such as TPA Desk, Finance & Accounts, Front Office, and Bill Dispatch Departments; ensuring smooth functioning of the TPA Process.
Performing troubleshooting during cashless approvals and pre & post-discharge of the patients for all units
Ensuring group's timely dispatch of credit invoices for payment recoveries
Reconciling accounts with all TPAs, Insurance Companies, and internal Finance Teams
Directing on-account (NEFT) settlement for ensuring timely settlement of NEFT payments, creating departmental MIS, reports, and presentations pertaining to TPA revenue, debtors aging, collection, deduction, old payment & NEFT (on-account) settlement for periodic review of team with higher management
Following-up for deduction and rejection of the TPA claims; reviewing & analysing Debtor Ageing and Daily Collection Reports
Monitoring day to day work of team on receivable software i.e., Eprapti.
To define and set the centralized TPA process.
Motivating the team and responsible for high team morale.

Experience & Qualifications:

Graduate, preferably with an MBA in Marketing or a Diploma in Marketing.
Preferably with 6 to 10 years of experience in healthcare of handling TPA / Insurance channel.
Strong Interpersonal skills and conflict resolution ability
Extremely strong Networking Skills
Good Organization and Planning Skills
Strong Relationship Management Skills
Strong focus on performance and Service Excellence

AGM/DGM (Health Insurance Administration & Receivables) Sales and Marketing