Looking for position for one of the institutes of Symbiosis International University i.e. Symbiosis University Hospital & Research Centre, Lavale, Pune

Hospital is 900 beds NABH Accredited, Multi-super Specialty State of the art hospital, associated with Symbiosis Medical College for Women.

Qualification and Experience

1. Graduate with 0 to 10 years of experience in Govt schemes /MJPJAY / PMJAY /ESIC / PMC / Maharashtra Police etc. in a multi-specialty Hospital
2. Good Computer & Communication Skills
3. Willing to work in rotational Shifts including mandatory night shifts

· Key areas of responsibility: Preauthorization -

- To manage the front desk at the government scheme department.
- To guide patients/ relatives through the complete process of the scheme.
- Obtain consent from patients / relatives for over and above package charges.
- Update Medical Officers about daily admissions admitted in Medicine/Surgery etc wards.
- Ensure Emergency Telephonic Intimation (ETI) is sent in emergency admissions as per scheme SOP.
- Ensure and follow the required documentation as per the guidelines of schemes.
- Ensure photographs/ video as per SOP of MJPJAY/ PMJAY.
- Communicate a list of approved cases to concerned stakeholders like, Discharge team, concerned wards.
- To send pre-authorization along with required documents to the concerned TPA/ authority as per TAT
- Confirm the timely receiving of authorization letters from TPA/ authority.
- Liaise with the floor manager, ward in-charge billing department, etc.
- Send preauthorization requests with supporting documents to the TPA / authority within the defined TAT.To ensure daily updating of on-bed in the portal.




- Keep Medical Officers / MCO informed about all preauthorization updates and case statuses.
- To ensure Office Permission (OP) of IPD patients.
- Change the patient’s class once the ETI taken and preauthorization is approved.

Discharge –

- Collect a file from the ward for the discharged patient on a daily basis in the morning
- Coordinate with ward staff nurses/ doctors for lab reports and other investigations as per package sop (e.g. surgery - intr-operative photos etc)
- To ensure a list of approved cases from team preauthorization on a daily basis.
- Cross-check the photographs/ video/ OT notes/ all medical documents are as per MJPJAY/ PMJAY approval with the help of the Medical Officer, to avoid queries/denial of cases.
- To communicate with the billing dept. about estimated charges as per procedure (e.g. surgeries performed/ stent for the cardiac patient)
- To ensure consent from patients/ relatives for over and above package charges.
- To ensure discharge photograph with the patient, Arogyamitra and MCO at MJPJAY desk
- To ensure discharge from the portal within 48 hrs of patient discharge.
- To liaise with the floor manager, ward in-charge billing department, etc.
- To ensure a start-to-end process of the discharge as per sop & TA.
- To appraise MO/ MCO in regard to the discharge process.




- To ensure patient satisfaction letter
- Scan discharge documents as per the criteria of MJPJAY scheme.

Claims –

- To check and ensure the submission of claim documents on the portal along with the bill as per TAT as per SOP (11 days after discharge).
- To check and identify the cases on the portal about the status of paid, rejected, and pending at the claim level and ensure immediate and necessary action.
- To check, verify, and ensure discharge documents are available in the patient file as per guidelines of MJPJAY/ PMJAY.(e.g. Post-treatment investigations)
- To check the portal for the status of the claim after 10 days from the submission of the document on the portal.
- To update MO/ Assistant Manager for claim doctor reject remark within 20 days from the date of rejection by team MJPJAY/ PMJAY.
- To coordinate activities amongst stakeholders and other departments of the hospital.
- To ensure and follow the required documentation as per the guidelines mentioned for schemes.
- To liaise with the floor manager, ward in-charge billing department, etc. for any documentation.
- To ensure a start-to-end process of the discharge as per sop & TAT.
- To coordinate and cooperate with colleagues of the same department and other related departments for smooth operations.
- To perform any other duties assigned by management from time to time.
- Along with the MJPJAY and PMC schemes online/ offline process of other government schemes

Job Types: Full-time, Permanent Pay: ₹16,000.00 - ₹30,000.00 per month

Perks

- Health insurance
- Paid sick time
- Provident Fund

Work Location: In person

📌 Billing Assistant - Govt. Scheme (Pune)
🏢 SYMBIOSIS INTERNATIONAL UNIVERSITY
📍 Pune