- Job Summary The Senior Executive – Billing & Insurance is responsible for managing and supervising hospital billing activities, insurance/TPA coordination, cashless and reimbursement processes, and ensuring accurate and timely submission of claims. The role requires close coordination with patients, doctors, nursing staff, insurance companies, TPAs, finance, and other hospital departments.
- Key ResponsibilitiesHospital Billing

- Manage and monitor IP and OP billing activities.
- Ensure accurate preparation of patient bills as per hospital tariffs and approved rates.
- Verify charges for consultations, procedures, investigations, pharmacy, room rent, consumables, and other services.
- Review bills before final submission and discharge.
- Ensure timely and accurate final billing for in-patients.
- Identify and resolve billing discrepancies, corrections, and pending charges.
- Handle patient and attendant queries related to billing and payments.
- Ensure proper documentation and maintenance of billing records.

Insurance & TPA Coordination
- Coordinate with insurance companies and TPAs for cashless approvals and claim processing.
- Process pre-authorizations, enhancement requests, final approvals, and discharge approvals.
- Verify insurance eligibility, policy details, coverage, exclusions, and applicable deductions.
- Ensure timely submission of required medical and billing documents.
- Coordinate with doctors and clinical departments for medical documents required for insurance approval.
- Follow up with TPAs/insurance companies regarding pending approvals and queries.
- Handle claim queries, rejections, deductions, and clarifications.
- Coordinate with the concerned departments for resolution of claim-related issues.
- Maintain proper records of cashless and reimbursement cases.

Claims & Documentation




- Ensure complete and accurate documentation for insurance claims.
- Check discharge summaries, investigation reports, prescriptions, operative notes, bills, receipts, and other required documents.
- Monitor pending claims and follow up for timely settlement.
- Maintain records of rejected, pending, and settled claims.
- Support the finance team in reconciliation of insurance and TPA payments.

Team Coordination & Supervision
- Guide and support billing executives in day-to-day billing activities.
- Monitor the performance and accuracy of billing staff.
- Allocate work and ensure smooth functioning of the billing and insurance desk.
- Train team members on billing procedures, insurance requirements, and hospital policies.
- Escalate critical billing and insurance issues to the reporting manager.

Compliance & Reporting
- Ensure billing and insurance activities are carried out as per hospital policies and applicable requirements.
- Maintain confidentiality of patient and insurance-related information.
- Prepare daily/weekly/monthly reports on billing, cashless cases, pending approvals, claims, rejections, and collections.
- Assist management during internal and external audits.
- Ensure proper handover and documentation of pending cases.

3. Required Skills & Competencies
- Good knowledge of hospital IP/OP billing procedures.
- Strong knowledge of health insurance and TPA processes.
- Knowledge of cashless authorization and claim settlement procedures.
- Good understanding of hospital tariffs,



packages, consumables, and billing rules.
- Excellent communication and coordination skills.
- Good numerical and analytical skills.
- Ability to handle patient and attendant queries professionally.
- Good computer skills, especially MS Excel and hospital billing software/HIS.
- Ability to work under pressure and meet deadlines.
- Strong attention to detail and accuracy.
- Positive team-handling and problem-solving skills.

4. Educational Qualification
- Graduate in B.Com / BBA / BBM / Hospital Administration / Healthcare Management or any relevant discipline.
- Additional qualification in Hospital Administration, Healthcare Management, Medical Coding, or Insurance will be an advantage.

5. Experience
- 2-3 years of relevant experience in hospital billing and insurance/TPA operations.
- Previous experience in handling IP billing, cashless approvals, insurance claims, and TPA coordination is preferred.

6. Key Performance Indicators (KPIs)
- Billing accuracy and timely completion.
- Timely cashless approvals and discharge clearances.
- Reduction in billing errors and claim rejections.
- Timely submission and settlement of insurance claims.
- Reduction in pending insurance/TPA cases.
- Patient satisfaction regarding billing and insurance support.
- Effective team coordination and productivity.
- Timely submission of required reports.

7. Working Conditions
- Willingness to work in hospital shifts, including weekends/holidays as per hospital requirements.
- Ability to handle high-volume billing and insurance cases during peak hours.
- Maintain professional behaviour and patient confidentiality at all times.

Pay: ₹2,957.85 - ₹30,000.00 per year

Benefits

- Flexible schedule
- Paid sick time
- Provident Fund

Work Location: In person

📌 Billing & Insurance Senior Executive/Incharge (Kalyan Nagar)
🏢 North Bangalore Hospital
📍 Kalyan Nagar