Head of Department

We're hiring for TPA head for our esteemed organization

Location - Jhandewalan

Company - Alankit Limited

Job Description TPA Head

Company Name - Alankit Limited

Location: Jhandewalan

Industry: Healthcare / Hospital / Insurance

Role Summary:

The TPA Head will be responsible for leading and managing all Third-Party Administrator (TPA) operations, ensuring seamless coordination between hospitals, insurance providers, TPAs, and internal teams. The role focuses on operational excellence, compliance, cost control, and superior service delivery.

Key Responsibilities:

Lead and oversee end-to-end TPA operations including empanelment, claims processing, and settlement

Act as the primary point of contact for all TPAs and insurance partners

Ensure timely processing, approval, and closure of cashless and reimbursement claims

Monitor TATs, rejection rates, deductions, and claim escalations

Develop and implement SOPs to improve efficiency and compliance

Handle high-value, complex, and escalated claims

Ensure adherence to IRDAI guidelines, hospital policies, and contractual terms

Coordinate with clinical, billing, finance, and front-office teams

Negotiate commercial terms and SLAs with TPAs and insurers

Track performance metrics and prepare MIS, dashboards, and management reports

Identify operational risks and drive continuous process improvements

Lead, mentor, and develop the TPA team

Manage audits and respond to insurer/TPA queries

Key Skills & Competencies:

Strong knowledge of health insurance, cashless & reimbursement processes

Expertise in TPA coordination and insurer negotiations

Leadership and team management skills

Excellent communication and stakeholder management

Analytical mindset with strong problem-solving skills

Qualifications & Experience:

Graduate/Postgraduate (Healthcare Management / Hospital Administration preferred)

815 years of experience in TPA/insurance operations

Prior experience in a leadership or head-level role is mandatory