Manage relationships with TPAs, insurers, corporate clients, and institutional partners for hospital operations. Oversee cashless approvals, pre-authorizations, claims, billing documentation, collections, and receivables from admission through discharge. Coordinate with clinical, finance, billing, and front-office teams; resolve claim discrepancies and escalations; monitor tariffs and contracts; support negotiations and renewals; prepare MIS reports; and develop new corporate and insurance partnerships.
Job Description – TPA / Corporate Manager
Location: Mumbai
Function:
Industry: Healthcare / Hospitals
Experience: 2–10 years
Employment Type: Full-time
We are looking for an experienced SSO – TPA / Corporate Manager to manage and strengthen relationships with TPAs, insurance companies, corporate clients, and other institutional partners for our hospital operations in Mumbai.
The role will be responsible for ensuring smooth cashless and corporate patient processes, timely coordination, revenue realization, and strong partner relationships.
Key Responsibilities- Manage day-to-day relationships with TPAs, insurance companies, corporates, and institutional clients.
- Ensure smooth processing of cashless approvals, pre-authorizations, extensions, and final approvals.
- Coordinate with clinical, billing, front office, and medical teams for timely documentation and claim processing.
- Monitor TPA/corporate cases from admission to discharge.
- Ensure timely submission of bills, documents, and claims to respective TPAs/insurers.
- Track and resolve claim-related queries, deductions, rejections, and discrepancies.
- Maintain and strengthen relationships with existing corporate and insurance partners.
- Identify opportunities for onboarding new corporate/insurance/TPA relationships.
- Monitor agreed tariffs, packages, rate contracts, and commercial terms.
- Coordinate negotiations and renewals of corporate/TPA agreements wherever required.
- Prepare MIS and reports related to TPA/corporate business, approvals, claims, collections, and outstanding amounts.
- Work closely with the finance and collections teams to improve realization and reduce outstanding receivables.
- Ensure compliance with hospital policies, contractual requirements, and applicable processes.
- Handle escalations from patients, corporate clients, and TPAs.
- Strong knowledge of TPA, insurance, cashless and corporate healthcare processes.
- Good understanding of hospital billing and claims.
- Strong communication and negotiation skills.
- Relationship management skills.
- Analytical and problem-solving ability.
- Strong coordination with cross-functional teams.
- Good command of MS Excel and MIS reporting.
Candidates from hospitals, healthcare organizations,healthcare service providers with relevant experience will only be considered.
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