Hospital TPA Cum Counsellor

Hospital TPA cum Counsellor

Organization: Purple Heron Hospitals

Department: Patient Services / Insurance Desk

Location: Sodala, Jaipur

Employment Type: Full-Time

About the RolePurple Heron Hospitals is looking for a compassionate, detail-oriented, and patient-focused professional for the role of TPA cum Counsellor. The candidate will be responsible for handling insurance/TPA processes while also counselling patients and attendants regarding treatment plans, financial estimates, and hospital services.

The ideal candidate should possess strong communication skills, coordination ability, and knowledge of hospital insurance procedures.

• Key ResponsibilitiesTPA & Insurance CoordinationHandle cashless hospitalization processes with TPAs and insurance companies.
• Coordinate pre-authorization, approval, enhancement, and discharge documentation.
• Verify patient insurance eligibility and policy coverage.
• Maintain proper documentation and ensure timely submission of claims.
• Liaise with insurance companies, corporate clients, and internal departments for smooth processing.
• Follow up on pending approvals and claim settlements.
• Maintain records of insurance claims, approvals, and rejections.
• Patient CounsellingCounsel patients and attendants regarding treatment procedures, estimated costs, and insurance coverage.
• Guide patients through admission, discharge, and billing processes.
• Explain hospital policies, packages, and payment options clearly.
• Address patient concerns empathetically and ensure a positive patient experience.
• Coordinate with doctors, nursing staff, billing, and operations teams for seamless patient support.
• Administrative ResponsibilitiesMaintain daily MIS and TPA reports.
• Ensure compliance with hospital policies and insurance protocols.
• Support front office and billing teams whenever required.
• Assist in improving patient satisfaction and service quality.
• Required QualificationsGraduate in any discipline (Healthcare/Hospital Administration preferred).
• Minimum [1–3] years of experience in hospital TPA/insurance handling and patient counselling.
• Knowledge of insurance portals and hospital billing systems.
• Strong interpersonal and communication skills.
• Proficiency in MS Office and hospital management software.
• Preferred SkillsAbility to handle patients with empathy and professionalism.
• Good coordination and multitasking abilities.
• Problem-solving mindset with attention to detail.
• Familiarity with NABH processes is an added advantage.
• Salary & BenefitsCompetitive salary as per industry standards
• PF, ESIC, and other applicable benefits
• Career growth opportunities
• Supportive and patient-centric work environment