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.
