Manager - TPA

Department Icon Insurance- General Insurance
93+ Applicants
Posted: 1 month ago
8-10 years
Delhi, Delhi
work from office

Posted: 1 month ago
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Applicants: 94+
Job Description
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Job Description

JOB DESCRIPTION

Manager (TPA) Front Office

MAX OVERVIEW:

Max Healthcare Institute Limited (MHIL), founded in 2000, is one of Indias largest private hospital chain with 22+ healthcare facilities. Being the Indias most valuable listed healthcare organisations, we have driven innovation and excellence in healthcare for 25 years. With a workforce of 35,000+, including 5,000+ clinicians and 12,000 nurses/paramedics, we deliver advanced care across key locations including Delhi NCR (Saket, Patparganj, Vaishali, Rajendra Place, Shalimar Bagh, Dwarka, Gurugram, Panchsheel Park, Noida, Lajpat Nagar, Bulandshahr), Mumbai, Mohali, Bathinda, Dehradun, Lucknow, and Nagpur.

We also operate Max@Homeamong Indias largest healthcare-at-home services in 12 citiesand Max Lab, offering 2,700+ tests in 50+ cities across North India.

Roel overview:

Responsible for overseeing insurance claim processing within the hospital, ensuring accurate medical documentation, timely approvals, and smooth coordination with Third Party Administrators (TPAs) and insurance companies. The role requires clinical expertise (MBBS) to validate treatments, justify procedures, and prevent claim rejections

ROLES AND RESPONSIBILITIES:

Insurance Claim Handling

  • Process cashless and reimbursement claims
  • Coordinate with TPAs
  • Ensure pre-authorization approvals

Documentation & Compliance

  • Verify patient records, discharge summaries
  • Ensure ICD coding accuracy
  • Maintain claim records

Coordination

  • Work with insurance desk, billing, doctors, and nursing staff
  • Resolve claim queries and rejections

Denial & Rejection Management

  • Handle claim rejections
  • Follow up for settlements
  • Reduce TAT (Turnaround Time)

Looking to get Placed? Try our Placement Guarantee Plan

Team Supervision

  • Manage TPA desk executives
  • Train staff on updated insurance policies
  • To be well groomed, punctual & adhere to company policies and practices.

Years of Experience:

  • 08-10 years of healthcare experience in the relevant work.

Qualifications:

  • MBBS/BDS/BHMS/BPT Preferably with PG Diploma in Hospital Management.

Any Other Specification:

Skills

Insurance

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About Company

We are one of India’s leading providers of comprehensive, seamless and integrated world class healthcare services. With a network of 14 hospitals, we offer treatment across all 29 specialties. We have 2300+ leading doctors with international level expertise who are committed to provide highest standards of medical excellence at a fraction of international costs. Our NABH and ISO accredited hospitals offer best in class services to our patients. We understand seeking medical treatment outside your home can be physically and mentally difficult. So at Max, we are eager to get you home!

We are one of India’s leading providers of integrated world class healthcare services. With a network of 17 hospitals, we offer treatment across all 30 specialties. We have 4800+ leading doctors with international level expertise.

Max Institute of Laparoscopic, Endoscopic and Bariatric Surgery under the Chairmanship of Padmashree Dr Pradeep Chowbey at Max Hospital, Saket, Delhi has taken a giant leap in Robotic surgery with the Next-Generation Robot- VERSIUS from Cambridge Medical Robotics. Dr Pradeep Chowbey and his team, hold a massive record of performing more than 90,000 major laparoscopic surgeries and have now pioneered the Next-generation robotic surgery. The vision is to provide cutting-edge technology for even common surgical conditions which till now has been restricted to only complex surgeries with other robots.

Versius is designed to provide Surgical excellence for common surgical conditions with all the advantages of laparoscopic surgery technique with 3-dimensional view, added precision, accuracy & safety. Versius can be used for all common surgical conditions like Gallbladder stones, Hernia, appendicitis, Gastro-esophageal reflux disease, Bariatric & Metabolic surgery (weight loss surgery), Fundoplication & other procedures.

Backed by Machine Learning & empowered by Artificial Intelligence, this next-generation robot enables a 3D view with a greater depth perception that empowers the surgeon to achieve greater precision with ease. Its robotic arms move up to 720 degrees for precise & efficient alignment which is not possible with a human arm.

Thirty years ago, the surgical fraternity witnessed a giant leap of faith from open to laparoscopic surgeries. It revolutionized the surgical landscape with the minimally invasive technique causing minimal pain, quick recovery and resumption of normal activities, excellent cosmetic results and shorter hospital stay. Patients could move around on the same day of surgery. It brought significant drop in post operative infection rates that were common due to long hospitalizations in open surgeries.

Now, with this next generation robot, the 3-dimesnional images and the easy maneuverability of the robotic arms, patient outcomes are achieved with greater precision and accuracy. This next-gen robot has an open console unlike other robots that have a tunnel like console and the surgeon does not have direct vision of the patient. However, Versius ensures the surgeon has a direct vision of the patient and has wholesome control with close monitoring of the minutest details of the patient during the surgery. The patient is up and about in a couple of hours after the surgery, can be discharged on the same/next day and resume normal diet and activities from the next day onwards. There is minimal/no blood loss and due to very small port sizes the patient gets excellent cosmetic results.

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Important dates & deadlines?

Application Deadline

04 May 26, 06:06 PM IST

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