Role & responsibilities
Manage end-to-end PMJAY/Ayushman Bharat portal operations.
Verify patient eligibility and package selection as per scheme guidelines.
Review medical records and ensure all required documents are complete before claim submission.
Validate that the selected treatment package matches the diagnosis, procedure, and supporting clinical documents.
Coordinate with doctors, nursing staff, billing, TPA, and medical records teams for claim completion.
Submit pre-authorizations, discharge requests, and final claims within prescribed timelines.
Track pending authorizations, queries, deficiencies, and claim settlements.
Resolve portal queries and coordinate for claim resubmissions whenever required.
Ensure compliance with PMJAY, state health schemes, and hospital SOPs.




Maintain accurate records and generate MIS reports related to claims and portal performance.
Guide and monitor the portal operations team to ensure smooth workflow.

Preferred candidate profile
Previously handled complete PMJAY claim operations independently.
Familiar with package approvals, claim settlements, audits, and deficiency management.
Robust attention to detail with the ability to ensure high claim acceptance rates.

Eligibility
Graduate in any discipline (Healthcare/Hospital Administration preferred).
26 years of relevant experience in PMJAY or government health scheme claim management.
Experience working in a hospital is preferred.

📌 Billing Executive New Delhi
🏢 Shri Khatu Shyam Healthcare
📍 New Delhi