VINAY SINGH RAWAT

• Worked at Health Insurance Assist as TPA Executive.(Tenure -1.8 year)

• Worked at Guru Nanak Hospital as TPA Coordinator ( Tenure1 year)

Hospital TPA & Claims Executive

Client: Fortis Hospital, Narayana Hospital, Paras Hospital, Cygnus Hospital, Aggarwal Hospital, Apollo Hospital, Apollo Cradle Company Name.| City |Abi Health Technology Pvt. Ltd. (Claimbook)

Responsibilities:

• Managed day-to-day TPA desk operations at multiple hospitals.
• Handled pre-authorization requests, approvals, enhancements, and query responses.
• Coordinated with TPAs, insurance for claim status, shortfalls, rejections, and settlement.
• Executed end-to-end claim dispatch with complete documentation.
• Performed settlement tracking, maintained settlement advice, and escalated pending claims.
• Prepared daily, weekly, and monthly MIS reports for management.
• Provided training to hospital billing, TPA desk staff, on TPA and claim software usage.
• Offered post-training support for issues such as claim uploads, document errors, or workflow doubts.
• Ensured accuracy in data entry, document uploading, and file preparation.
• Maintained strong relationships with hospital billing teams and TPA representatives.
• Improved claim approval rates by ensuring compliance with insurer documentation requirements.

• Working at Pristyn Care (GHV Advanced Care Pvt Ltd ) since March 2021 till now.