TPA Manager

Company Description Kanishk Surgical & Super Specialty Hospital is a NABH-accredited hospital established in 2011 and centrally located in Dehradun, the capital of Uttarakhand, India. The hospital offers comprehensive, world-class healthcare across multiple specialties, including advanced laparoscopy, gastroenterology, oncology and palliative care, orthopedics, neurosurgery, general medicine, obstetrics and gynecology, nephrology, urology, critical care, and more. It emphasizes ethical, compassionate, and affordable patient care, with a strong commitment to clinical excellence and timely treatment. Regular seminars and live surgery workshops are held in a modern auditorium, supporting continuous learning and professional growth. The medical and support teams are dedicated to delivering high-quality, patient-centered services without compromise.

Role Description This is a full-time, on-site TPA Manager role based at Kanishk Surgical & Super Specialty Hospital in Dehradun. The TPA Manager will oversee all Third-Party Administrator (TPA) and corporate insurance operations, including patient empanelment, pre-authorization processing, and coordination of cashless and reimbursement claims. Responsibilities include verifying patient eligibility and coverage, liaising with TPA representatives and insurance companies, and ensuring timely submission and settlement of claims. The role involves regularly updating and maintaining TPA agreements, tariffs, and documentation, as well as monitoring denied or delayed claims and driving prompt resolution. The TPA Manager will collaborate with medical, billing, and front office teams to ensure accurate documentation, compliance with hospital and payer policies, and clear communication with patients and their families regarding insurance processes. The position also includes preparing periodic reports, tracking key performance indicators, and recommending process improvements to enhance efficiency and patient experience.

Qualifications

• Strong knowledge of TPA operations, health insurance processes, cashless and reimbursement workflows, and hospital billing practices.
• Experience in coordinating with insurance companies, TPAs, government panels, corporate clients, and internal clinical and non-clinical teams.
• Proficiency in hospital information systems, claim management software, and basic MS Office tools (Excel, Word, email communication).
• Excellent communication, negotiation, and interpersonal skills to manage patient queries, resolve disputes, and maintain professional relationships.
• Attention to detail, strong organizational skills, and the ability to manage multiple cases and deadlines simultaneously.
• Understanding of relevant healthcare regulations, documentation standards, and compliance requirements related to insurance and TPAs.
• Bachelor's degree in Hospital Administration, Healthcare Management, Commerce, or a related field; a master's degree or specialized training in healthcare finance or administration is an advantage.
• Prior experience in TPA management, hospital billing, or health insurance in a