Posted last month
TPA Manager
@ Eye-Q Vision Pvt Ltd
Burlington, Ontario
Overview
Eye-Q Eye Hospitals is hiring a full-time TPA Manager to oversee third-party administrator relations and the smooth processing of patient claims. The role covers daily TPA operations, compliance with policies and regulations, and coordination with insurers, providers and internal departments. Preferred qualifications include a bachelor's degree in healthcare or business administration and prior TPA or healthcare experience.
Responsibilities:
- Manage TPA relationships and claim processing
- Oversee claim submission and approval
- Coordinate billing discrepancies and claim accuracy
- Analyze claims data and prepare TPA performance reports
Requirements summary:
- Strong medical billing and coding knowledge
- Familiarity with healthcare regulations and TPA compliance
- Proficiency in healthcare software and EHR systems
- Strong analytical and communication skills
- Bachelor's degree preferred
Tools & skills
Source and dates
Source type not verified · apify-linkedin
- Employer posting date
- 2026-10-02
- First seen by our source
- 2026-11-15
- Source record updated
- 2026-11-15
These dates describe the source record, not a live verification that the employer is still hiring. Check the original posting.
Job details
| Seniority | Manager |
| Department | Business operations |
| Manages people | Yes |
| Hours per week | 40 (estimated) |
| Work setting | Office, Hospital or clinic |
| Position | Mostly sitting |
| Physical demands | physical low · computer high |
| Education | Bachelor’s degree (preferred) |
| Fields of study | Healthcare Administration, Business Administration |
Summary and details written by AI from the posting; the employer’s posting is the authority.
Eye-Q Vision Pvt Ltd
| Field | Value |
|---|---|
| Open jobs on Jobsy | 1 |
Job Title: TPA Manager
Job Description:
The TPA Manager will be responsible for managing the Third-Party Administrators (TPA) relations and ensuring smooth processing of patient claims. The role involves overseeing the daily operations related to TPA functionalities and ensuring compliance with established policies and procedures. The TPA Manager will collaborate closely with insurance providers, healthcare providers, and internal departments to streamline claim processes, resolve issues, and enhance operational efficiencies.
Key Responsibilities:
- Establish and maintain relationships with TPA organizations to facilitate claim processing and payment.
- Oversee the claims submission and approval processes, ensuring timely and accurate processing.
- Coordinate with the billing department to address any discrepancies and ensure correct claim submissions.
- Monitor and analyze claims data to identify trends and areas for improvement.
- Provide training and support to staff regarding TPA-related processes and practices.
- Ensure compliance with applicable regulations and standards in TPA operations.
- Act as a liaison between patients, healthcare providers, and TPAs to resolve claims-related issues.
- Prepare regular reports on TPA performance and claim status for management review.
Skills and Tools Required:
- Strong knowledge of medical billing and coding, particularly in relation to TPA processes.
- Excellent communication and interpersonal skills for effective relationships with internal and external stakeholders.
- Proficiency in healthcare management software and Electronic Health Records (EHR) systems.
- Strong analytical skills to assess claim data and identify trends.
- Attention to detail to ensure accuracy in claims processing and documentation.
- Problem-solving abilities to resolve claims-related issues efficiently.
- Familiarity with healthcare regulations and compliance standards related to TPAs.
- Ability to work in a fast-paced environment and manage multiple tasks simultaneously.
Preferred Qualifications:
- Bachelor’s degree in Healthcare Administration, Business Administration, or a related field.
- Previous experience in TPA management or a similar role within the healthcare industry.
- Knowledge of relevant healthcare laws and guidelines.
Journal
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