TPA Manager

Silver Streak Multi-Speciality Hospital is seeking a detail-oriented and experienced TPA Manager to lead and streamline the hospital’s Third-Party Administrator (TPA) operations. The ideal candidate should have minimum 5 years of experience in a TPA cell within a hospital setting and be well-versed in handling the complete cycle of patient approvals, claims processing, reconciliations, and recovery follow-ups. The role also involves coordination with insurance companies, empanelment of new TPAs, and ensuring timely collections and documentation.

Key Responsibilities:

• Oversee the end-to-end TPA process, including patient pre-authorization, final approval, and billing coordination.
• Liaise with various insurance companies and TPAs to ensure smooth communication and claim settlement.
• Handle reconciliations and timely follow-ups for outstanding payments and shortfalls.
• Monitor turnaround time for approvals, and ensure minimal delays in patient discharge processes.
• Maintain accurate and updated documentation for all TPA-related interactions and audits.
• Coordinate with clinical and non-clinical departments to ensure complete and compliant claim submissions.
• Prepare and share regular MIS reports and dashboards related to TPA collections, rejections, and receivables.
• Manage and onboard new TPAs, corporates, and insurance panels for expanding the hospital’s network.
• Address queries from patients and insurers with professionalism and clarity.

Skills & Qualifications:

• Graduate in any discipline; additional qualifications in Hospital Administration or Healthcare Management are preferred.
• Minimum 5 years of relevant experience in the TPA department of a hospital.
• Strong understanding of TPA protocols, insurance guidelines, and hospital billing systems.
• Excellent communication and negotiation skills to handle insurance partners and patients.
• Proficiency in MS Excel, hospital information systems (HIS), and TPA software.
• Ability to manage time-sensitive processes under pressure with high attention to detail.
• Knowledge of relevant statutory regulations, including IRDA guidelines.

Preferred Attributes:

• Prior experience handling multiple TPAs and insurance providers.
• Strong analytical skills with a proactive approach to recovery and reconciliation.
• Ethical, process-driven, and focused on continuous improvement.
• A team player who can also independently take ownership of key functions.

Why Join Us?

• Be part of one of the region’s leading multi-speciality hospitals with a strong TPA and corporate network.
• Opportunity to manage critical revenue functions and contribute to financial health.
• Work in a system-driven environment with opportunities for professional growth.

Job Title: TPA Manager
Department: Accounts and Billing 
Location: Silver Streak Super Speciality Hospital
Reporting To: Billing Manager
Experience Required: Minimum 5 years
Qualification: Graduate in any discipline; preference for candidates with a background in healthcare administration or billing department
Job Type: Full-time