The ECHS Executive is responsible for handling all processes related to the Ex-Servicemen Contributory Health Scheme (ECHS), including patient verification, referral processing, pre-authorization, billing, and claim submission, ensuring smooth and timely cashless treatment for ex-servicemen and their dependents.
Key Responsibilities:
- Verify ECHS Smart Card and patient eligibility
- Check and process ECHS referral forms
- Coordinate with ECHS Polyclinic for approvals and clarifications
- Handle pre-authorization requests through the ECHS portal
- Ensure proper documentation for cashless treatment
- Prepare and submit ECHS claim files as per guidelines
- Follow up for claim approval, deficiencies, and settlements
- Coordinate with doctors, MRD, billing, and nursing departments
- Maintain accurate records of ECHS patients and claims
- Ensure compliance with ECHS rules, package rates, and SOPs
- Assist patients and attendants in understanding ECHS procedures
Documentation Handling:
- ECHS Smart Card copy
- Referral form from Polyclinic
- KYC documents (if required)
- Investigation reports, discharge summary
- Final bill, implant stickers (if applicable)
- Claim submission checklist as per ECHS norms
Qualification:
- Any Graduate (BBA / B.Com / Hospital Administration preferred)
- Knowledge of Government health schemes is an advantage
Experience:
- 0–3 years in ECHS / CGHS / Insurance / TPA handling
- Freshers with strong knowledge can be considered
Skills Required:
- Solid knowledge of ECHS guidelines and portal process
- Good communication & coordination skills
- Knowledge of hospital billing & medical terminology
- Computer proficiency (MS Office, HIS, ECHS portal)
- Attention to detail & documentation accuracy
Key Performance Indicators (KPIs):
- Timely pre-authorization and approvals
- Error-free claim submission
- Reduction in claim rejections/queries
- Fas