TPA Manager

Job Title: TPA Manager Organization: Cygnus Superspeciality Hospital, Kurukshetra Department: TPA / Insurance Reports To: Hospital Administrator / Operations Head Job Summary: The TPA Manager will lead the hospital’s TPA and insurance operations, ensuring smooth processing of cashless and reimbursement claims. This role involves team management, coordination with TPAs and insurance companies, revenue protection, and process improvement. Key Responsibilities: • Manage all TPA and insurance operations of the hospital • Lead, guide, and monitor the TPA Executive team • Maintain strong relationships and coordination with insurance companies and TPAs • Supervise pre-authorization, enhancement, and final claim approvals • Minimize claim rejections, deductions, and delays • Personally handle high-value and critical cases • Coordinate with billing, clinical, and front office teams • Ensure implementation of TPA policies, tariffs, and package rates • Prepare and review daily/monthly MIS reports, ageing analysis, and settlement tracking • Ensure compliance with insurance audits and documentation requirements • Develop and implement SOPs for process improvement and revenue optimization • Provide regular updates to management on team performance and revenue metrics Required Skills & Competencies: • Strong knowledge of health insurance, TPAs, and IRDA guidelines • Excellent team leadership and people management skills • Strong communication and negotiation skills • Problem-solving and decision-making ability • Advanced MS Excel and hospital billing software knowledge • Ability to perform effectively under pressure Qualifications: • Graduate / Postgraduate (preferably in Hospital Administration, Healthcare, or Management) • Certification in health insurance or TPA operations is an advantage Experience: • 5–8 years of experience in hospital TPA/insurance operations • 2–3 years of experience in team handling (Senior TPA Executive or Assistant Manager level) • Experience in hospitals preferred Location: Cygnus Superspeciality Hospital, Kurukshetra Job Type: Full-time Pay: ₹10,000.00 - ₹25,000.00 per month Experience: • total work: 2 years (Preferred) Work Location: In person