Medical Officer – TPA Claim Process
2 days ago
Job Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: Vadodara Reporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination between hospital departments, doctors, and TPA representatives.Key Responsibilities:Examine and verify patients’ medical records, treatment plans, and discharge summaries for insurance claim processing.Coordinate with treating consultants to obtain medical justifications or clarifications required by the TPA.Scrutinize pre-authorization and final bill submissions as per TPA and insurance guidelines.Ensure correctness of ICD codes, procedures, and diagnosis in the claim documents.Review claim queries and prepare appropriate medical responses or justifications.Liaise with TPA coordinators, hospital billing, and admission teams to ensure smooth cashless approval and reimbursement flow.Maintain accurate claim records and ensure timely submission of documents to TPAs.Monitor and track pending and rejected claims, ensuring resolution in coordination with the TPA team.Ensure compliance with TPA policies, medical ethics, and hospital protocols.Provide medical support to the TPA operations team for claim audits and reconciliation.Required Qualifications & Skills:MBBS / BHMS / BAMS / equivalent medical qualification (MCI-registered preferred).1–3 years of experience in hospital TPA claim processing or medical audit.Sound knowledge of health insurance policies, cashless & reimbursement claim processes.Strong analytical and documentation skills.Proficiency in MS Office and hospital management software (HMS).Good communication and coordination abilities.
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Medical Officer – TPA Claim Process
1 day ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: VadodaraReporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination between...
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Medical Officer – TPA Claim Process
2 hours ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: VadodaraReporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination between...
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Medical Officer – TPA Claim Process
2 days ago
vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim Process Department: TPA / Health Insurance Desk Location: Vadodara Reporting To: TPA Manager / Operations Head Job Summary: The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Officer – TPA Claim Process
2 days ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim Process Department: TPA / Health Insurance Desk Location: Vadodara Reporting To: TPA Manager / Operations Head Job Summary: The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Officer – TPA Claim Process
1 day ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim Process Department: TPA / Health Insurance Desk Location: Vadodara Reporting To: TPA Manager / Operations Head Job Summary: The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Officer – TPA Claim Process
2 days ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: VadodaraReporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Officer – TPA Claim Process
2 days ago
Vadodara, India Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: Vadodara Reporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Medical Officer – TPA Claim Process
3 days ago
Vadodara, Gujarat, India, Gujarat Nucleon Health Full timeJob Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: Vadodara Reporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination...
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Non Mbbs Doctor for Claim Processing
3 days ago
Vadodara, India FAMILY HEALTH PLAN INSURANCE TPA LTD Full time**Overview Of FHPL** Family Health Plan Insurance TPA Limited (FHPL), incorporated in the year 1995 and licensed by IRDAI in the year 2002 is today one of the largest and most reputed IRDAI Licensed Third Party Administrator (TPA) in the country. FHPL with its Registered and Corporate office at Hyderabad has presence in over 55 locations and 25 states...
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Counselor Tpa Coordinator
3 days ago
Subhanpura, Vadodara, Gujarat, India Centre For Sight Full timePrior experience in TPA coordination or related roles - Strong knowledge of TPA processes, regulations, and best practices - Excellent communication and interpersonal skills - Ability to handle multiple tasks and prioritize effectively - Manage the end-to-end process of insurance claims from initial intake to settlement. - Review claim documentation for...
