Role Overview

Department

Revenue Cycle Management / Billing Audit

Reporting To

Senior Manager / Manager Revenue Assurance & Operational Excellence

Role Purpose

The Executive Revenue Assurance is a frontline audit role responsible for conducting day-to-day billing audits across assigned clinical areas, identifying discrepancies at the point of billing, and preventing revenue leakage before final claim submission. The incumbent is the primary interface between the audit function and clinical / nursing teams on the floor.

This is a detail-oriented, field-based role requiring a thorough understanding of hospital billing workflows, procedure coding, HIS systems, and clinical documentation standards.

Key Responsibilities

1. Daily Billing Audit Assigned Areas

Conduct daily billing audits for all active and discharged patient files within the assigned floor / ward / ICU area

Verify that all procedures, consumables, consultations, and monitoring charges are accurately billed and reflected in the HIS

Identify and flag discrepancies: missed billing, wrong procedure codes, duplicate entries, missed cross-consultations, and unbilled services

Reconcile clinical documentation (nursing notes, procedure records, doctor orders) against the HIS bill to ensure charge capture accuracy

Submit daily audit reports to the Senior Manager with item-wise bifurcation of revenue loss prevented (RLP)

2. HIS Billing Verification

Cross-check Hospital Information System (HIS) entries for each patient against actual services rendered

Flag delayed billing, wrong payor mapping, incorrect package inclusion or exclusion, and missing add-on charges

Ensure all procedure charges are entered within defined TAT post-service delivery

Escalate HIS system errors, auto-billing failures,



or missing charge triggers to the IT / HIS team via the reporting manager

3. Procedure & Code Verification

Verify that procedure codes are correctly applied for each clinical service

Cross-reference high-value billable items including arterial line insertions, IV cannulation, Ryle's tube insertion, ABG, DVT pump, ventilator management, Foley's catheterisation, oxygen charges, and monitoring devices (e.g. Dozee / EMVS)

Identify wrong code selection and coordinate correction with billing executives before bill finalisation

Maintain a code reference guide for frequently billed procedures in the assigned clinical area

4. Floor Coordination & Communication

Liaise daily with nursing in-charge, ward staff, and treating team assistants to obtain procedure confirmation for billing

Follow up on pending documentation required to support audit findings and billing corrections

Communicate audit discrepancies to the billing desk for timely correction prior to patient discharge

Participate in daily audit briefings and submit floor-level findings to the reporting manager

5. Compliance & Documentation

Maintain accurate records of all files audited, discrepancies identified, and corrections initiated

Ensure compliance with billing activity targets ( 95%) and HIS billing compliance targets for the assigned area

Follow escalation protocols for unresolved billing disputes or documentation gaps

Adhere to hospital SOPs, patient confidentiality norms, and NABH / JCI billing compliance requirements

Technical

Hospital billing and charge capture workflows

HIS / HMIS data entry and verification

Procedure code identification ICD-10, hospital-specific codes

Understanding of insurance, TPA, and cash billing formats

MS Excel — audit tracking, daily reporting

If interested kindly share your CV to "[email protected]"

Regards

📌 Urgent Hiring- Executive (Revenue Assurance) (Delhi)
🏢 Artemis Medicare
📍 Delhi