Job Summary: Responsible for maintaining revenue by establishing, implementing, and controlling billing system.
Receive payment from all patients for the hospital services provided.
- Submit all related documents like reports, bills and discharge summary to concerned internal departments for final approval and settlement
- Process all insurance TPAs and resolve their queries (TPAs as well as patients) to get the approval for payment clearance.
- Coordinating with TPA Network team regarding reconciliation, billing queries like, over billing justification/ PPN Package issues & resolving.
- Ensure transactions are correctly recorded of both OPD and IPD functions also maintaining the records & register for IPD.
- To check the accuracy of the bills on daily basis, before the same could be circulated to the patients/attendants.
- Responsible generation of daily reports & submitting the same to the manager.
- Responsible for cash & credit billing (Insurance) for in-patient department.
- Explaining the cash / TPA (Third Party Administration) insurance package to the patients and initiating backend process by sending all the insurance documents to the respected TPAs for the final settlement.
- Daily checking the insurance patients and discuss with their consultants about their treatments & stay of hospitalization.
- Daily Updating of Hospital Inpatient, census for pending payments, cashless/ approval status in TPA cases.
- Responsible for maintaining all TPAs (Third Party Administrator) data and MIS.
- To maintain a valuable relationship with TPAs for smooth functioning of the department.
- Interact with all the internal and external auditors and answer queries if any.
- Ensure all the documents are filled as per audit requirement and shared with the respective departments on a timely basis.
- Ensure timely resolution of patient queries (discounts/ billing/ packages etc.) and counsel them on insurance related matters if any.
- To co-ordinate with other departments like Pharmacy, OT Stores & Materials Stores for smooth flow of discharge process.
- To interact with cross function teams to receive/ share updates timely
- Any other portfolio that may be entrusted by the management from time to time.
Educational Qualifications: B.com/ MBA
Work Experience:
- 2+ years of experience in Billing Department.
- Good communication and interpersonal skills
- Accurate processing of information both verbal and written
- Demonstrates high attention to detail with ability to solve problems on hand
- Should demonstrate patience and confidence when dealing with customer enquiries and complaints
- Strong attention to details
Expected Deliverables:
- Ensuring zero billing discrepancies
- Accurate filing and maintenance of bills (online and offline)
- Timely processing of insurance claims with TPAs
- 100% compliance to statutory and internal audits
- Resolving customer queries and ensure zero escalations