Open to opportunities

VAGAHOSPITAL User

@vagahospitaluser

Message

TPA Head and Billing specialist improving cashless claims, documentation, and insurance performance.

India

Message

What I'm looking for

I want to be associated with a progressive organization, extract and develop my inherent skills as a professional, and apply my aptitude to help achieve the organization’s objectives while attaining my career targets.

I’m a Dedicated TPA Coordinator and currently work as a TPA Head and Billing, where I oversee billing processes to ensure accuracy and compliance with industry standards. I coordinate TPA workflows with hospitals and insurance partners, resolve claim-related discrepancies, and keep comprehensive patient records to support clinical decision-making and audits.

I collaborate with healthcare teams to streamline patient care pathways—managing admissions, insurance verification, and patient communication to enhance satisfaction and speed up access to services. I’ve also led practical TPA initiatives like 100% cashless conversion, claim rejection reduction, portal-based submission, TAT improvement, insurance empanelment expansion, outstanding recovery, and desk SOP standardization through training and process improvement.

Experience

Work history, roles, and key accomplishments

Current

TPA Head and Billing

Current

CGHS-Eye In Vaga Hospital

Jun 2025 - Present (1 year)

Oversaw billing processes to ensure accurate documentation and compliance with hospital and industry standards. Supported training programs for new staff to improve operational efficiency and continuous improvement.

Medical Billing Insurance Claims Processing Operational Efficiency Audit Support Cashless Support

TPA Head

Sharavani Healthcare Hospital

Nov 2023 - May 2025 (1 year 6 months)

Coordinated patient care pathways by managing admissions and maintaining accurate documentation aligned with hospital policies. Streamlined insurance verification and resolved claim discrepancies to help patients access services faster.

TPA Administration Patient Admissions Insurance Verification Compliance Documentation Process Coordination

TPA Coordinator

Pawars Urology & Gayne Super Specialty NABH Hospital

Jul 2022 - May 2025 (2 years 10 months)

Collaborated with healthcare teams to coordinate patient care pathways and streamline processes across the TPA desk workflow. Managed communication between patients and medical staff while maintaining comprehensive documentation for support and audits.

Care Pathways Communication Management NABH Support Medical Documentation Insurance Verification Audit Support Workflow Management

TPA Co-ordinator

Medox Hospital

Jul 2021 - Apr 2022 (9 months)

Assisted clinical staff with improving patient billing by supporting accurate documentation and TPA-related workflows. Strengthened team coordination through clear verbal and written communication with stakeholders.

Patient Billing Support Team Collaboration Compliance Support Quick Learning Process Improvement