Company Description Volo Health Insurance TPA Private Limited (IRDA License No. 18) is a licensed Third Party Administrator (TPA) authorized by the Insurance Regulatory & Development Authority (IRDA) since May 16, 2002. The company specializes in healthcare-related administration services for insurance providers and corporate clients. Its core offerings include designing medical plans, processing and administering healthcare claims, and delivering managed healthcare services.

Volo Health

Insurance TPA focuses on efficient, compliant, and customer-centric claims management to support insurers and organizations in delivering quality health coverage.

Role Description This is a full-time, on-site role for a Claim Processing Doctor based in Hyderabad.

The Claim Processing

Doctor will review and assess medical documents, treatment plans, and hospitalization records submitted for health insurance claims. The role involves validating clinical information, determining medical necessity and eligibility as per policy guidelines, and providing clear, well-documented medical opinions. The doctor will coordinate with internal claims teams, insurers, hospitals, and other healthcare providers to clarify medical details and ensure timely resolution of claims.

The position also includes maintaining accurate records,



supporting adherence to regulatory and company standards, and contributing to process improvement initiatives in claims management.

Qualifications

- BAMS/ BHMS/ BUMS/ MBBS with valid registration from the appropriate medical council.
- Clinical experience in hospital or healthcare settings; exposure to health insurance or TPA operations is an advantage.
- Strong understanding of medical terminology, clinical protocols, diagnostic procedures, and treatment standards.
- Ability to interpret medical records, laboratory reports, and discharge summaries for claims assessment.
- Attention to detail, analytical thinking, and sound clinical judgment in evaluating medical necessity and appropriateness of care.
- Effective written and verbal communication skills to explain medical decisions to non-medical stakeholders.
- Comfort using computer-based claim processing systems, electronic medical records, and standard office software.
- Ability to work in office in Hyderabad, collaborate with cross-functional teams, and manage time-sensitive case volumes.
- Commitment to ethical practice, patient confidentiality, and compliance with IRDA and organizational guidelines.

📌 Claim Processing Doctor (Hyderabad)
🏢 Volo Health Insurance TPA
📍 Hyderabad