Lalit Kumar

To work with a challenging and stimulating environment with opportunities to enrich my knowledge and skills and to grow with the organization.

TPA Coordinator - Dr. Kapur's The Healing Touch Eye and Maternity Centre - D-8, Vikas Puri, New Delhi-110018

(2024-05)

Presently Working with M/s Dr. Kapur's The Healing Touch Eye and Maternity Centre as a TPA Coordinator

• CGHS OPD handling Pensioner patient, documents verification, Prepare billing in visual software and upload all CGHS cases in TMS portal
• Patient counselling about of package for TPAs
• Prepare Baby birth certificate of MCD portal in hospital login
• Prepare the MIS Report on a Monthly basis
• Coordinator with TPA and Insurance Company for initial approval and Final approval for Cashless and IPD billing all cases
• Coordinator with TPA and Insurance Company for Hospital Empanelment
• Coordinator to TPA and Insurance Company for payment and cashless approval
• Dispatched to TPA File for payment and resolve TPA query
• Pre-Auth and Final Bill & Discharge share with TPA and Insurance Company by Mail or Hospital TPA Portal
• All TPA check investigation reports and other documents
• Date prepares for pending payment to all TPA and insurance companies
• Coordinator for TPA and insurance company pending payment
• Prepare the All TPA and Insurance Companies surgery Bills
• Query Reply for Initial and Final Approval
• All TPA work from Hospital

TPA Coordinator - MEDFIRST ENT CENTRE - D-3/14, Vasant Vihar, New Delhi-110057

(2021-11 - 2024-04)

Worked with M/s Med First ENT Centre as a TPA Coordinator

• Prepare the MIS Report on a Monthly basis
• Coordinator with TPA and Insurance Company for initial approval and Final approval for Cashless and IPD Billing all cases
• Coordinator with TPA and Insurance Company for Hospital Empanelment
• Coordinator to TPA and Insurance Company for payment and cashless approval
• Dispatched to TPA File for payment and resolve TPA query
• Pre-Auth and Final Bill & Discharge share with TPA and Insurance Company by Mail or Hospital TPA Portal
• All TPA check investigation reports and other documents
• Date prepares for pending payment to all TPA and insurance companies
• Coordinator for TPA and insurance company pending payment
• Prepare the All TPA and Insurance Companies surgery Bills
• Query Reply for Initial and Final Approval
• All TPA work from Hospital

TPA Coordinator - PARAS HOSPITAL VAISHALI GHAZIABAD - Plot No 130, Sector 4, Vaishali, Ghaziabad

(2019-07 - 2020-12)

Worked with M/s Paras Hospital as an TPA Coordinator

• Prepare the MIS Report of Monthly basis
• Coordinator to TPA and Insurance Company for payment and cashless approval
• Dispatched to TPA File for payment and resolve TPA query
• Prepared to discharge summary and resolve query for patient attendants and TPA
• All TPA check investigation reports and other document
• Date prepare for pending payment to all TPA and insurance company
• Coordinator for TPA and insurance company pending payment

Executive (Accounts Dept)–Corporate Health Claim Deptt - M/S IFFCO TOKIO GENERAL INSURANCE CO. - Iffco Tower, Sec.-29, 3rd Floor, Plot No 3, Gurgaon

(2012-01 - 2017-04)

Worked with M/s Iffco Tokio General Insurance Company under contract Saiber Consulting, Hyderabad as an Executive in Accounts Department, Corporate Health Claim Department

• Prepare the MIS Report of Daily, Weekly, Monthly, Yearly basis
• Process the Service Fees to 14 TPAs as pre SLA signed by TPA
• Process the payment of Legal Cases and Advocates Fees
• Booking of Co-Insurance in P400 on basis of SBU's Mail
• Support in In-House Claim Payment Process (Individual & Group) as well as Claim Payment Letter send to Client/Insured
• External Payment Process (Group) of 14 TPA
• Maintaining the Master Data of Daily Payable Payments
• We receive the Data to TPA for process the claim for payment to Hospital or Insured from our Central Accounts Team
• Provide the UTR No & Transferred Date to TPAs day to day along with solve the query of Branches & Client
• Handling the Grievance Cases

Coordinator (Investigation Dept.) Executive - E-MEDITEK TPA LTD

(2010-04 - 2011-12)

Worked with E-Meditek TPA Ltd as a Coordinator in Investigation Department

• Coordinate with our Investigators
• Coordinate with Hospital and Patients for investigation purpose
• Coordinate our branch
• Prepare the MIS Report of Daily, Weekly, Monthly, Yearly basis

MIS Executive - Next Gen Publishing Ltd

(2008-09 - 2010-02)

Worked with Next Gen Publishing Ltd (A joint venture of forbes and HDFC Bank Ltd) as a MIS Executive

• MIS Reporting
• Mapping data of other data
• MIS Type-Agent wise, Product Wise Trigger Wise & Dashboard
• Prepare the MIS Report of Daily, Weekly, Monthly, Yearly basis

MIS Executive - Tata AIG Life Insurance Company Ltd

(2007-03 - 2008-08)

Worked with Tata AIG Life Insurance Company Ltd as a MIS Executive

• Scrutinizing and Filling of new business application
• Handing to agency channel
• MIS Type-Agent wise, Product Wise Trigger Wise & Dashboard
• Prepare the MIS Report of Daily, Weekly, Monthly, Yearly basis
• Handling Un-delivered Document
• Cash & Cheque Entry in system

10+2 - CBSE Delhi (2000)

Matriculation - CBSE Delhi (1998)

BA - Delhi University