1. Hospital Billing

- Prepare accurate OPD, IPD, Emergency and procedure bills.
- Enter services, investigations, medicines, procedures and consumables correctly in the hospital software.
- Verify billing entries before final bill generation.
- Handle advance payments, refunds, adjustments and final settlement.
- Collect cash, card, UPI and other approved payment modes and maintain proper records.
- Coordinate with pharmacy, laboratory, radiology, nursing and other departments for billing-related information.
- Ensure correct application of hospital rates, packages, discounts and approvals.
- Maintain daily billing and collection reports.

2. Reception / Front Office Support

- Patient registration and creation of UHID/IPD records.
- Verify patient demographic and identification documents.
- Guide patients and relatives regarding admission, discharge, billing and payment procedures.
- Handle basic reception enquiries and coordinate with concerned departments.
- Maintain proper patient documentation and confidentiality.

3. Mediclaim / Insurance

- Handle insurance and mediclaim patient registration and documentation.
- Verify insurance policy/card and required patient documents.
- Collect KYC, policy, Aadhaar/ID and medical documents as applicable.
- Coordinate for insurance eligibility and approval.
- Prepare and submit pre-authorization and claim-related documents.
- Follow up on pending approvals, queries and claim requirements.
- Coordinate with the insurance company for claim clarification and settlement.

4. Cashless Processing

- Handle cashless admission and pre-authorization process.
- Prepare and submit cashless request forms/documents to the insurance company/TPA.
- Coordinate with the TPA/insurance desk for approval.
- Communicate approval status and approved amount to the concerned department/patient.
- Process enhancement requests whenever treatment cost exceeds the approved amount.




- Coordinate for final authorization before discharge.
- Ensure complete documentation for cashless claim submission.

5. TPA Coordination

- Coordinate with various TPAs for patient eligibility, authorization and claim processing.
- Prepare and submit required TPA documents within the prescribed timeline.
- Respond to TPA queries and provide supporting documents.
- Maintain records of pending approvals, queries and rejected/settled claims.
- Coordinate with the Medical Records, Billing, Accounts and Clinical Departments for claim documentation.
- Follow up on outstanding TPA/insurance cases.

6. CGHS Billing

- Handle CGHS patient registration and billing-related documentation.
- Verify CGHS beneficiary details and required documents.
- Understand CGHS package/rate-related billing requirements.
- Prepare bills as per applicable CGHS rules, packages and approved rates.
- Coordinate for required authorization/referral documents.
- Maintain CGHS-related records and supporting documents.
- Coordinate with concerned departments for proper documentation and claim submission.

7. Discharge & Final Settlement

- Prepare patient final bills after verification of all services.
- Coordinate with nursing, pharmacy, laboratory, radiology and other departments before discharge.
- Verify insurance/TPA/CGHS approval against the final bill.
- Collect balance amount or process eligible refund.
- Ensure all required discharge billing documents are complete.

8. Daily Reporting & Documentation

- Prepare daily collection and billing reports.
- Maintain cash, card,



UPI and online payment records.
- Maintain insurance/TPA/cashless pending case reports.
- Maintain proper records of approvals, queries and claim documents.
- Submit daily/weekly reports to the reporting authority.

Required Knowledge & Skills

- Knowledge of Hospital Billing & Front Office Operations.
- Knowledge of OPD/IPD/Emergency billing.
- Working knowledge of Mediclaim and Health Insurance.
- Knowledge of Cashless Authorization Process.
- Knowledge of TPA coordination and claim documentation.
- Basic knowledge of CGHS billing and packages.
- Good knowledge of hospital billing software/HMIS.
- Basic knowledge of MS Excel and MS Word.
- Valuable communication and patient-handling skills.
- Good numerical and documentation skills.
- Ability to coordinate with doctors, nursing, accounts, insurance companies and TPAs.
- Ability to work under pressure and meet billing/claim timelines.

Qualification & Experience

- Qualification: Graduate preferred; B.Com/BBA or relevant qualification preferred.
- Experience: 1–3 years in hospital billing, front office, insurance, TPA or cashless desk preferred.
- Candidates with experience in Hospital Billing + TPA + Mediclaim + Cashless + CGHS will be preferred.

Key Performance Areas (KRA)

- Billing accuracy and timely bill generation.
- Minimum billing errors and corrections.
- Timely cashless/pre-authorization processing.
- Proper TPA/insurance documentation.
- Timely response to insurance/TPA queries.
- Accurate daily collection and billing reports.
- Patient satisfaction and professional communication.
- Proper coordination for smooth discharge and final settlement.
- Compliance with hospital policies and applicable billing/insurance procedures.

Pay: ₹15,000.00 - ₹16,000.00 per month

Benefits:

- Paid sick time
- Provident Fund

Work Location: In person

📌 Billing Executive (Saijpur Bogha)
🏢 Anand Surgical hospital
📍 Saijpur Bogha