1. Job Purpose

To lead and manage the Group Credit function with overall responsibility for government and TPA empanelments, revenue realization, outstanding collections, rejected and disallowed claims, government notices, statutory/license tracking, and revenue enhancement across all hospital units.

The position will ensure timely claim resolution, reduction in rejections and disallowances, faster collection of outstanding dues, effective government liaisoning, and continuous improvement in credit and revenue-cycle processes.

2. Key ResponsibilitiesA. Government Empanelment & Business Development

- Drive government and institutional empanelment across all hospital units.
- Lead empanelment with NHA/PMJAY, ECHS, Railway, CGHS, ESIC, RGHS and other government panels.
- Ensure timely completion of documentation, applications, inspections, follow-ups and approvals.
- Develop and maintain strong liaison with concerned government departments and authorities.
- Identify opportunities for current government/institutional business.
- Monitor empanelment status through a centralized tracker and ensure timely closure.

B. TPA Empanelment & Business Growth

- Drive TPA empanelment across all units.
- Ensure completion of TPA empanelment within defined timelines.
- Develop strategies to increase TPA business across the group.
- Monitor unit-wise TPA business and identify opportunities for growth.
- Coordinate with operations, billing, medical and insurance teams to improve conversion and realization.

C. Outstanding Collection & Credit Control

- Take ownership of outstanding receivables, particularly dues pending for more than three months.




- Work closely with the concerned team members for collection from ECHS, Railway, CGHS, ESIC, TPA and other government/institutional payers.
- Prepare unit-wise and payer-wise ageing analysis.
- Categorize outstanding balances based on collectability, documentation issues, disputes and payment status.
- Establish action plans for recovery of long-pending dues.
- Ensure closure of eligible outstanding balances within defined timelines.
- Escalate critical and disputed cases to management with a clear action plan.

D. Rejected & Disallowed Claims Management

- Analyze old and current rejected claims under CGHS, ESIC, TPA and other panels.
- Identify the root causes of rejections, deductions and disallowances.
- Develop corrective and preventive actions to reduce recurring rejections.
- Coordinate with billing, medical records, operations and concerned departments for claim correction and resubmission.
- Track rejected cases from identification to final payment closure.
- Establish systems to prevent rejection due to documentation gaps or delayed responses.

E. Notices, Government Liaison & Compliance

- Coordinate responses to notices received from government departments and institutional payers.
- Ensure all notices are replied to within prescribed timelines.
- Liaise with ABH, RGHS and other government departments for clarification,



resolution and process improvement.
- Maintain a centralized notice tracker.
- Monitor recurring issues and implement corrective measures.
- Ensure proper documentation and records of all official communications.

F. License & Regulatory Tracker

- Develop and implement a centralized License Tracker for all hospital units.
- Monitor validity and expiry dates of licenses, registrations, approvals and renewals relevant to the Credit/Government Business function.
- Ensure renewal processes are initiated well before expiry.
- Coordinate with concerned departments and external authorities for timely renewal.
- Implement the license tracker through available software/system and ensure regular updating.

G. Revenue Enhancement – Laboratory & Pharmacy

- Identify opportunities to improve Laboratory and Pharmacy revenue.
- Analyze conversion rates, referral patterns and utilization.
- Work with unit teams to identify gaps in conversion.
- Develop initiatives to improve patient conversion and revenue realization.
- Monitor monthly performance and implement corrective actions where required.

H. Process Improvement & MIS

- Establish standardized credit processes across all units.
- Develop dashboards and MIS for:
- Government empanelment
- TPA empanelment
- Outstanding receivables
- Ageing
- Rejections
- Disallowances
- Notices
- Licenses
- Revenue conversion
- Conduct regular review meetings with unit teams.
- Identify process gaps and introduce corrective and preventive measures.
- Ensure accurate and timely reporting to management.

Pay: ₹600,000.00 - ₹1,200,000.00 per year

Work Location: In person

📌 Group Head -Credit (India)
🏢 Apex Hospital, Malviya Nagar
📍 India