Tpa Doctor (Dwarka)

Tpa Doctor (Dwarka)

08 Nov
|
Max Healthcare
|
Dwarka

08 Nov

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
- Share

Register And Apply 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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