Transaction Processing Executive

Responsibilities:

• Handling TPA related all process from billing to co-ordinate with TPA companies.
• Responsible for counseling patient's family & pre-Auth process.
• Maintaining & uploading patient's files on the portal.
• Couriering the hard copy of patient's medical file to the Insurance companies.
• Responsible for all co-ordination activities from patient's admission to discharge.
• Handling billing Department, Implants bill updating & reconciliation.
• Daily co-ordination with the patient and Hospital staff.
• Preparing split bills/ Doctor charges etc.
• Handling all TPA Portals.
• Outstanding follow-up with TPA.
• Monthly Review report.
• To obtain and review referrals and authorizations for treatments.
• To follow and adhere to all regulations and guidelines set by state programs, and HMO/PPO, etc.
• Must be aware of norms of the insurance sector.
• Daily follow up with Insurance companies to pass or clear the Health Insurance