JOB DESCRIPTION – for Billing Department

Job Purpose

To supervise and ensure accurate, timely and compliant billing operations for all hospital patients and payer categories, including Cash, CGHS, ECHS, ESI, TPA, Insurance, Ayushman, Corporate and PSU clients.

The Senior Billing Executive will be responsible for monitoring the complete billing cycle, coordinating with clinical and support departments, ensuring timely discharge, preventing revenue leakage and supporting timely claim submission and settlement.

Key Responsibilities

1. Overall Billing Operations

· Supervise day-to-day billing activities for all payer categories.

· Ensure accurate and timely posting of all patient services in HIS.

· Verify charges for investigations, pharmacy, procedures, OT, implants, consumables, room rent, doctor fees and other services.

· Ensure that no billable service is missed or incorrectly charged.

· Monitor pending bills, unposted charges and billing discrepancies.

· Ensure billing is carried out as per approved hospital tariff, packages, contracts and payer-specific rates.

2. Cash Billing

· Supervise cash patient billing and collection.

· Ensure proper calculation of patient payable amount.

· Monitor advances/imprest and outstanding amounts during IPD stay.

· Ensure collection of outstanding amounts before discharge wherever applicable.

· Verify refunds, cancellations and adjustments as per approved process.

· Ensure proper reconciliation of daily collections with HIS.

3. CGHS / ECHS / ESI Billing

· Ensure billing as per applicable CGHS, ECHS and ESI rates, packages and guidelines.

· Verify package applicability, room entitlement, investigations, procedures, medicines, implants and other billable items.

· Ensure required documents and approvals are available.

· Monitor deductions,



queries and discrepancies raised by the respective authorities.

· Coordinate with the concerned team for timely correction and resubmission.

4. TPA & Insurance Billing

· Ensure bills are prepared according to the applicable insurance/TPA agreement and approved rates.

· Verify pre-authorisation and final approval requirements.

· Ensure proper application of package rates, negotiated rates, discounts and exclusions.

· Coordinate with TPA/insurance teams regarding approvals, queries and deductions.

· Ensure final bills are prepared and submitted within defined timelines.

· Monitor pending claims and coordinate for resolution of outstanding queries.

5. Ayushman Billing

· Ensure billing as per Ayushman package and portal guidelines.

· Verify package selection, procedures, consumables, implants and applicable documentation.

· Ensure required portal entries and supporting documents are complete.

· Monitor pending cases, rejected cases, queries and deductions.

· Coordinate with the Ayushman team for timely submission and resolution.

6. Corporate / PSU Billing

· Ensure billing according to approved corporate/PSU agreements and rate contracts.

· Verify applicable discounts, packages, exclusions and payment terms.

· Ensure proper documentation and approval for credit billing.

· Monitor outstanding corporate receivables and coordinate with the concerned team.

7. IPD Billing & Discharge Management





· Monitor billing of all IPD patients throughout their hospital stay.

· Review patient bills regularly to identify missing or incorrect charges.

· Ensure timely posting of pharmacy, investigations, procedures, OT, implants and consumables.

· Coordinate with nursing, pharmacy, laboratory, radiology, OT, purchase, MRD and other departments for pending charges.

· Review final bills before discharge.

· Ensure discharge billing is completed within the defined TAT.

· Monitor cases where discharge is delayed due to pending billing, approval, documentation or payment.

· Ensure attendants are provided accurate information regarding outstanding amounts.

8. HIS & Billing Configuration

· Ensure correct use of HIS for all billing transactions.

· Verify tariff, package, payer rates, discounts and other billing configurations.

· Report incorrect rates, missing codes, incorrect mapping or system-related billing issues.

· Coordinate with IT/HIS teams for correction of billing configurations.

· Ensure approved payer agreements and rate structures are properly mapped in HIS.

· Minimise manual billing adjustments and ensure all corrections are properly authorised.

9. Claim Submission & Settlement Coordination

· Monitor timely submission of completed bills/claims.

· Ensure all required documents are attached before submission.

· Track pending submissions, queries, deductions and rejected claims.

· Coordinate with the submission and settlement teams for timely resolution.

· Analyse recurring deductions and billing errors and suggest corrective measures.

· Maintain proper records of pending and submitted claims.

Pay: ₹20,000.00 - ₹35,000.00 per month

Advantages:

- Cell phone reimbursement
- Flexible schedule
- Paid sick time
- Provident Fund

Work Location: In person

📌 Billing Executive (Agra)
🏢 UJALA CYGNUS RAINBOW HOSPITAL, AGRA
📍 Agra