TPA Manager

TPA Management:

• Oversee the day-to-day activities of contracted TPAs.
• Ensure adherence to SLAs, KPIs, and regulatory requirements.
• Evaluate and monitor TPA performance through audits and reports.
• Coordinate training and knowledge-sharing sessions with TPAs.

Claims Oversight:

• Supervise claims adjudication, settlement, and dispute resolution.
• Ensure timely and accurate claims processing.
• Review complex/high-value claims and provide decision support.

Vendor Coordination:

• Manage TPA onboarding, renewal, and contract negotiations.
• Establish strong relationships with TPA partners to ensure smooth collaboration.

Compliance & Reporting:

• Ensure TPA operations comply with IRDAI (for India) or local regulatory guidelines.
• Generate reports on claims trends, fraud detection, and TPA performance.
• Assist in internal/external audits and implement corrective measures.

Customer Experience:

• Address and resolve escalated complaints related to TPA services.
• Work with customer service teams to improve end-user satisfaction.

Job Type: Full-time

Pay: ₹25,000.00 – ₹40,000.00 per month

Work Location: In person