Pratham Joshi

Motivated and dedicated healthcare professional seeking opportunities in a reputed organization where I can contribute to organizational success while continually developing my skills. Committed to learning, growth, and delivering high-quality results.

Junior Executive (TPA Department) - BhaktiVedanta Hospital & Research Institute - Mumbai, Maharashtra, India

(2025-02-03 - 2026-04-08)

• Prepared and issued detailed cost estimates for non-Mediclaim (self-pay) patients, explaining applicable tariffs, package inclusions, exclusions, and revision scenarios.
• Managed end-to-end TPA / Mediclaim process including insurance verification, pre-authorization, enhancement requests, documentation review, and final claim settlement.
• Differentiated and applied separate billing tariffs for Mediclaim and non-Mediclaim patients, ensuring correct charge capture as per hospital-approved rate cards.
• Coordinated with billing, nursing, medical records, and clinical teams to ensure services rendered were accurately reflected in estimates and final bills.
• Reviewed admission, treatment, and discharge-related documents to support accurate billing and minimize discrepancies.
• Liaised with TPAs and insurance companies to resolve query letters, deductions, and denials within defined timelines.
• Counseled patients and attendants regarding tariff differences, insurance limitations, non-payable items, and out-of-pocket expenses in a clear and transparent manner.
• Ensured compliance with hospital SOPs, insurance guidelines, and internal control procedures.

Manager - Digi-Hub Connecting Ports

(2022-04 - 2024-05)

• Oversaw daily operations and inventory management.
• Set competitive pricing aligned with market trends.
• Implemented quality assurance through inspection and testing procedures.

Junior Intern - Mehta & Vasu Chartered Accountants

(2022-01 - 2022-03)

• Worked on Tally for purchase, sales, and bank entry processing.
• Maintained and updated financial records using Microsoft Excel.

Bachelor of Banking and Insurance - Banking and Insurance - Nagindas Khandwala College, Mumbai University (2019 - 2022)

Higher Secondary Certificate - B.S.G.D. Junior College, Maharashtra State Board (2018 - 2019)