Head of Department

We're hiring for TPA head for our esteemed organization

Location - Jhandewalan

Company - Alankit Limited

Job Description – TPA Head

Company Name - Alankit Limited

Location: Jhandewalan

Industry: Healthcare / Hospital / Insurance

Role Summary:

The TPA Head will be responsible for leading and managing all Third-Party Administrator (TPA) operations, ensuring seamless coordination between hospitals, insurance providers, TPAs, and internal teams. The role focuses on operational excellence, compliance, cost control, and superior service delivery.

Key Responsibilities:

• Lead and oversee end-to-end TPA operations including empanelment, claims processing, and settlement

• Act as the primary point of contact for all TPAs and insurance partners

• Ensure timely processing, approval, and closure of cashless and reimbursement claims

• Monitor TATs, rejection rates, deductions, and claim escalations

• Develop and implement SOPs to improve efficiency and compliance

• Handle high-value, complex, and escalated claims

• Ensure adherence to IRDAI guidelines, hospital policies, and contractual terms

• Coordinate with clinical, billing, finance, and front-office teams

• Negotiate commercial terms and SLAs with TPAs and insurers

• Track performance metrics and prepare MIS, dashboards, and management reports

• Identify operational risks and drive continuous process improvements

• Lead, mentor, and develop the TPA team

• Manage audits and respond to insurer/TPA queries

Key Skills & Competencies:

Strong knowledge of health insurance, cashless & reimbursement processes

Expertise in TPA coordination and insurer negotiations

Leadership and team management skills

Excellent communication and stakeholder management

Analytical mindset with strong problem-solving skills

Qualifications & Experience:

• Graduate/Postgraduate (Healthcare Management / Hospital Administration preferred)

• 8–15 years of experience in TPA/insurance operations

• Prior experience in a leadership or head-level role is mandatory