TPA Doctor

Company Description

Sarvodaya Healthcare is a leading 1200-bedded, multi-specialty healthcare group operating across Faridabad, Greater Noida, Mathura, Delhi, and other NCR cities. Renowned for its advanced infrastructure, compassionate approach, and high standards, the network delivers integrated care across specialties including Cardiac Sciences, Cancer Care, Orthopaedics, and Emergency Services. Equipped with cutting-edge technologies such as robotic surgery systems and precision radiotherapy, Sarvodaya ensures world-class medical treatment, better outcomes, and faster recovery. Accredited by NABH and recognized by AHPI for excellence in healthcare, the group is dedicated to ethical and patient-centric care. Sarvodaya Healthcare embodies expertise and empathy, serving communities with innovation and trust.

Role Description

This is a full-time, on-site position for a TPA Doctor, based in Faridabad. The TPA Doctor will review medical records, process and evaluate claims, and ensure compliance with healthcare policies and regulations. The role includes liaising with patients, hospitals, and insurance providers to facilitate claim approvals and address any issues. Additionally, the TPA Doctor will assist in monitoring pre-authorizations, medical approvals, and budget allocations for treatment, ensuring seamless coordination and maintaining patient-centric services.

Qualifications

• Strong understanding of medical documentation, diagnosis coding, and treatment planning.
• Proficiency in claim processing, pre-authorizations, and collaboration with insurance companies.
• Excellent communication and interpersonal skills to work with patients, staff, and insurance providers.
• Knowledge of healthcare regulations, patient rights, and ethical practices in medical claims.
• Ability to work in a fast-paced, on-site healthcare environment with attention to detail and patient care.
• MBBS or equivalent medical qualification; experience in a similar role or understanding of TPA operations is preferred.