- Coordinate with all stakeholders for smooth implementation of the Ayushman Bharat/PM-JAY process.
- Ensure all required patient and treatment documents are correctly uploaded on the AB portal.
- Ensure proper Maker & Checker compliance for all cases.
- Coordinate with hospital departments for timely documentation and claim processing.
- Monitor pre-authorisation, claim submission, queries, and settlement processes.
- Provide training and guidance to COP/front-office staff regarding the Ayushman Bharat process.
- Prepare and maintain daily/monthly MIS and reports related to Ayushman Bharat cases.
- Ensure timely responses to queries raised by the Ayushman Bharat authorities.
- Track pending cases and follow up with concerned departments for closure.
- Identify process gaps/challenges and escalate them to management with suitable solutions.
- Maintain proper records and ensure compliance with applicable guidelines and hospital policies.
The PM-JAY hospital workflow includes activities such as pre-authorisation and claim submission, so these are relevant areas for the coordinator role.
Qualification: Graduate in any discipline; healthcare/insurance/TPA-related qualification preferred.
Experience: 2–5 years of experience in Ayushman Bharat/PM-JAY, TPA, cashless, insurance claims, or hospital billing preferred.