Tpa Doctor (Dwarka)

Tpa Doctor (Dwarka)

12 Sep
|
Max Healthcare
|
Dwarka

12 Sep

Max Healthcare

Dwarka

MHC/27545
- Front Office
- Dwarka-Max Super Speciality Hospital
Posted On
22 May 2026
End Date
05 Jun 2026
Required Experience
5 - 7 Years
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Basic SectionNo. Of Openings

1

Designation

Deputy Duty Manager 1

Employee Category

Front Office

Closing Date

05 Jun 2026
SkillsSkill

Required Qualification

MEDICAL
Job Description- Review patient files, diagnosis, and treatment plans for cashless approval:
- Coordinate with TPA/insurance companies for pre-authorization and enhancement approvals
- Evaluate medical necessity of investigations, procedures, and length of stay
- Prepare and submit justification notes for queries raised by TPAs




- Handle claim rejections and deductions with proper clinical reasoning
- Ensure accurate and complete documentation (case sheets, discharge summary, reports)
- Follow up on pending approvals and escalate critical cases
- Support billing team in final claim settlement:
- Maintain compliance with insurance and hospital policies
- Monitoring Approval rate / reduction in rejections
- Maintained TAT for pre-authorization and query closure
- Reduction in billing deductions
- Quality of documentation and compliance

📌 Tpa Doctor (Dwarka)
🏢 Max Healthcare
📍 Dwarka

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