Job Title TPA DOCTOR
Category Healthcare
Location New Delhi
Company Max Healthcare
Description 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
Salary Not Disclosed
Last Date 2026-05-30 00:00:00
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