JOB SUMMARY

We are looking for a detail-oriented and process-driven PM-JAY Incharge to manage the complete PM-JAY workflow at the hospital from patient registration to claims documentation. The role requires strong coordination skills, portal proficiency, and a qualified approach to patient handling.

Roles & Responsibilities

You shall be responsible for, but not limited to, the following:

Counselling patients and their attendants regarding cashless treatment, corporate empanelments, insurance, and PMJAY (Ayushman Bharat) benefits.

Coordinating the complete pre-authorization process with insurance companies, TPAs, and government agencies.

Ensuring timely submission of pre-authorizations, enhancement requests, and all claim-related documentation.

Maintaining complete and accurate inpatient documentation as per NABH, TPA, and PMJAY guidelines.

Coordinating with consultants, nursing staff, the billing department, and MRD for seamless patient care and documentation.

Ensuring proper discharge documentation, including discharge summaries, investigation reports, prescriptions,



consent forms, and billing records.

Submission of final claims within prescribed timelines.

Regular follow-up with insurance companies, TPAs, PMJAY authorities, and other government agencies for claim approval and settlement.

Ensuring timely recovery of dues from insurance companies, TPAs, corporate clients, and government agencies.

Monitoring claim rejections and taking corrective measures to minimize denials.

Preparing daily, weekly, and monthly reports related to admissions, approvals, pending claims, collections, and outstanding payments.

Maintaining cordial professional relationships with TPAs, insurance companies, government officials, and corporate organizations.

Ensuring compliance with all hospital policies, NABH standards, statutory regulations, and quality protocols.

Performing any additional responsibilities assigned by the Hospital Management from time to time.

REQUIR

📌 PM-JAY In Charge (Patna)
🏢 Satyavrat Hospital
📍 Patna