TPA & Billing In-Charge

Key Responsibilities:

• Oversee the complete TPA and insurance billing workflow.
• Manage Ayushman Bharat (PMJAY) approvals, pre-authorizations, documentation, and claims submission.
• Ensure accurate billing, coding, and timely processing of claims.
• Coordinate with doctors, nurses, and billing staff to verify documentation accuracy.
• Follow up on pending claims, rejections, queries, and settlements with insurance providers.
• Prepare MIS reports and ensure compliance with government and insurance guidelines.
• Train, guide, and mentor billing staff on TPA and Ayushman processes.