Reporting To: Hospital Manager / Ayushman In-charge
Key Responsibilities
Verify Ayushman beneficiary eligibility and complete patient registration.
Handle BIS/TMS entries and documentation.
Submit and follow up on pre-authorizations and enhancements.
Coordinate with doctors for required medical documents and clarifications.
Update treatment and discharge details in TMS.
Prepare and submit final claims within the prescribed timeline.
Monitor queries, rejected claims and resubmissions.
Maintain Ayushman registers, records and daily/monthly MIS.
Track pending and outstanding claims and coordinate with Accounts for payment reconciliation.
Coordinate with Front Office, Billing, Nursing,
Medical Records and Accounts departments.
Ensure compliance with PM-JAY guidelines and hospital SOPs.
Provide proper guidance to Ayushman patients and attendants regarding the cashless process.
Qualification Graduate; experience in Ayushman/TPA/Insurance/Hospital Billing preferred.