TPA Coordinator Jobs in Coimbatore Insurance Company

📋 Job Description

Jobzi is sourcing qualified candidates for TPA Coordinator positions in Coimbatore's private Insurance Company sector. This is a full-time opportunity with a reputed Insurance and Financial Services employer in Coimbatore offering competitive salary, structured growth, and a professional work environment. Tamil communication skills are preferred alongside English for professional and business interaction in Coimbatore.

📌 Key Responsibilities

• Process cashless hospitalization pre-authorization requests from network hospitals within IRDAI-mandated timelines
• Coordinate between policyholders, hospitals, and the insurance company for smooth cashless claim processing
• Verify patient eligibility, policy coverage, and waiting period applicability for cashless approvals
• Handle reimbursement claim document collection and initial scrutiny for completeness
• Communicate authorization decisions and claim status to hospitals and policyholders
• Manage query responses to hospitals and patients on coverage, sub-limits, and exclusions
• Maintain cashless claim TAT records and prepare daily authorization MIS reports

🎓 Qualifications and Requirements

• Any graduate degree with 1-4 years of health insurance or TPA operations experience
• Knowledge of health insurance policy terms, sub-limits, exclusions, and cashless procedures
• Familiarity with TPA platforms: Medi Assist, Vipul Medcorp, Heritage Health, or MD India
• Basic medical terminology knowledge for reviewing pre-authorization requests and diagnosis
• Good customer communication skills for hospital staff and patient interaction
• IRDAI health insurance guidelines awareness for cashless settlement norms
• Ability to work in shift-based operations for 24/7 hospitalization support
• Good Tamil and English communication skills for team coordination and client interaction in Coimbatore.

✅ Required Skills

🏆 Certifications and Qualifications

IRDAI Insurance Agent License, POSP Certificate, IRDA Composite License, NISM Series certifications, IC-33 (Life Insurance), IC-38 (General Insurance), IC-57 (Health Insurance), Licentiate / Associate / Fellow of Insurance Institute of India (III)