Head - Cashless & TPA - Healthcare Industry

Job Responsibilities :

- Responsible for TPA Empanelment's for the Existing as well as Upcoming Centres.

- Responsible to ensure timely renewal of empanelment's with GIPSA/ Insurance Companies

- Responsible for proper price negotiation with GIPSA & Insurance companies

- Responsible for streamlining cashless process, design, develop and improve standard operating procedures pertaining to claims operations.

- Responsible to strengthen the claim operations by streamlining billing operations (Financial collections, deductions, timely clearance of Insurance cases and intervene in denial cases

- Responsible to build relationship with TPA's and TPA associated corporates.

- Responsible to maintain center wise database on Insurance empanelment's.

- Ensure regular visits to Centres and perform ongoing audit checks on claim submissions, denials, clearance for each center.

- Responsible to publish reports and Dashboard for periodic management reviews (Analysis Cash Vs Credit), (GIPSA Vs Insurance Cases)

- Responsible for facilitating camps with corporate for business enhancement.

- Responsible for other projects and assignments as assigned time to time basis part of the job role.

Functional Competency :

- Prior experience on working with TPA/GIPSA/Institutions

- Strong collaborative ability to sustain relationships within the organization & externally.

- Strong networking skills