Executive – TPA & Insurance

Job Description

Be Well Hospitals is seeking an Executive – TPA & Insurance to manage insurance claims and third-party administrator (TPA) processes efficiently. The role involves coordinating with insurance companies, verifying policy eligibility, processing cashless approvals, and ensuring timely claim settlements. The executive will support patients by providing accurate insurance-related guidance and documentation. The ideal candidate should have knowledge of health insurance procedures and excellent coordination skills.

Key Responsibilities
Process cashless hospitalization requests with TPAs and insurance providers.
Verify patient insurance eligibility and policy coverage.
Prepare and submit claim documentation accurately.
Coordinate with insurance companies for approvals and claim settlements.
Resolve claim-related discrepancies and follow up on pending cases.
Maintain accurate insurance records and billing documents.
Provide insurance guidance and support to patients and their families.
Ensure compliance with hospital, TPA, and regulatory requirements.