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
