Durga Pandit
Healthcare Billing and TPA Executive
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About
Experienced Healthcare Billing and TPA Executive with 6+ years of experience in hospital operations, insurance claim processing, and corporate billing. Skilled in IPD/OPD billing, cashless processes, claim settlement, and MIS reporting. Proven ability to manage multiple tasks efficiently while ensuring accuracy and compliance.
Experience
Billing – TPA Associate - Medicover Hospital - Ch. Sambhajinagar
(2022-08 - 2023-06)
- Managed TPA and corporate billing processes
- Handled insurance claim processing and pre-authorization
- Maintained discharge TAT and ensured billing accuracy
- Prepared and updated daily MIS reports
Billing Executive – TPA Department - KIMS (Kingsway Hospitals) - Nagpur
(2020-09 - 2022-01)
- Managed IPD billing including COVID cases
- Handled TPA, corporate, and CGHS billing processes
- Performed claim settlement and reconciliation
- Followed up on pending claims and payments
- Prepared daily and monthly MIS reports
- Managed reimbursement claims and recovery
- Handled billing and coordination for CGHS, Central Railway, NTPC, BHEL, WCL, AAI and MPKAY schemes including file submission and recovery
Front Office Executive (Level 2) - American Oncology Institute - Nagpur
(2019-04 - 2020-04)
- Handled IPD, OPD and day care billing
- Managed TPA processes and billing
- Maintained patient records and daily trackers
- Coordinated patient counselling and follow-ups
- Updated MIS reports and patient data
Customer Care Executive - Icon Hospital (Med Cash Pvt. Ltd) - Nagpur
(2018-01 - 2019-03)
- Managed IPD/OPD operations and patient handling
- Performed billing and package counselling
- Handled CGHS and corporate billing submissions
- Managed cashless and TPA processes
- Resolved patient queries and complaints
TPA Coordinator - Mandhaniya Cancer Hospital & Research Institute
(2016-11 - 2017-12)
- Managed insurance empanelment process
- Coordinated with insurance companies
- Followed up for claim approvals and recovery
- Maintained patient billing and insurance records
Back Office Executive - Pulse Diagnostic Center - Nagpur
(2015-03 - 2016-11)
- Managed CGHS billing and UTI uploads
- Maintained patient data and reports
- Coordinated corporate health checkups
- Handled PCPNDT submissions
Education
Bachelor of Arts - B.A.
Polytechnic - Civil Engineering
SSC - State Board (2012)
