TPA Executive

Criticare Asia Hospital is seeking a proactive and detail-oriented TPA Executive to manage insurance and third-party administrator (TPA) processes, ensuring smooth cashless approvals, timely claim settlements, and a seamless patient experience. The involves coordination with insurance providers, patients, and internal departments while maintaining compliance with hospital and regulatory guidelines.

Roles & Responsibilities

• Handle end-to-end TPA and insurance processes for cashless and reimbursement cases.
• Verify patient insurance details, policy coverage, and eligibility criteria.
• Process pre-authorization requests and obtain timely approvals from TPAs/insurance companies.
• Prepare, review, and submit accurate documentation for claims and approvals.
• Coordinate with billing, front office, and clinical teams for seamless patient processing.
• Manage admission and discharge processes for TPA patients.
• Follow up with TPAs/insurers for claim approvals, queries, and final settlements.
• Track pending claims, approvals, and payments to ensure timely closure.
• Handle claim rejections, queries, and discrepancies with proper resolution.
• Maintain complete and accurate records of all TPA transactions and communications.
• Ensure compliance with hospital policies, insurance guidelines, and regulatory requirements.
• Assist patients and relatives in understanding insurance processes and documentation.
• Provide prompt resolution to patient and insurer queries with professionalism.
• Support billing team in reconciliation of TPA-related accounts.
• Maintain proper filing and documentation for audit and verification purposes.
• Prepare MIS reports on claim status, approvals, rejections, and outstanding cases.
• Coordinate for empanelment and corporate tie-ups if required.
• Ensure confidentiality of patient and financial information.
• Support internal and external audits by providing required documents.
• Continuously improve processes to enhance efficiency and patient satisfaction.

CritiCare Asia Multispeciality Hospital is a modern healthcare institution dedicated to providing comprehensive and high-quality medical services. The hospital focuses on delivering patient-centric care through advanced technology and a team of experienced healthcare professionals.

Our Story

CritiCare Asia Multispeciality Hospital was established with the vision of offering accessible and reliable healthcare services under one roof. Over time, it has built a reputation for clinical excellence, compassionate care, and commitment to patient well-being.

Our Mission

• To provide high-quality and affordable healthcare services
• To ensure patient safety and clinical excellence
• To deliver compassionate and ethical care
• To continuously adopt advanced medical technologies

Our Vision

To be a leading multispeciality hospital recognized for excellence in healthcare services and patient satisfaction.

Our Services / What We Offer

CritiCare Asia Multispeciality Hospital offers a wide range of healthcare services:

• Multi-speciality consultations and treatments
• Advanced diagnostic and imaging services
• Surgical and critical care services
• Emergency and trauma care
• Preventive healthcare and wellness programs

Why Choose Us

• Comprehensive multispeciality care under one roof
• Experienced team of doctors and healthcare professionals
• Advanced infrastructure and modern medical technology
• Patient-centric approach with focus on safety and comfort
• Commitment to quality healthcare services

Our Team

The hospital is supported by a team of skilled doctors, surgeons, nurses, and healthcare staff dedicated to delivering effective and compassionate care.

Infrastructure / Technology

CritiCare Asia Multispeciality Hospital is equipped with state-of-the-art infrastructure and advanced medical equipment to ensure accurate diagnosis and effective treatment.

Our Commitment

CritiCare Asia Multispeciality Hospital is committed to improving healthcare outcomes by delivering safe, reliable, and high-quality medical services. The hospital emphasizes innovation, ethical practices, and patient satisfaction.