– Billing Staff

GEM Hospital & Research Centre Pvt. Ltd.

1. Key roles and responsibilities

A. Patient registration and billing
- Register patients and verify demographic details, hospital registration numbers, and other required information.
- Generate accurate bills for OPD consultations, laboratory investigations, radiology, procedures, and other services as applicable.
- Verify service entries against authorized orders, service records, and approved tariffs.
- Ensure correct selection of billing codes, service descriptions, quantities, and applicable taxes, where relevant.
- Collect consultation fees, deposits, advance payments, and outstanding balances according to hospital policy.
- Issue receipts for all payments and provide patients with clear explanations of billing particulars.
- Correct billing errors only through approved adjustment, cancellation, and authorization procedures.

B. Inpatient billing and discharge
- Maintain and update inpatient bills during hospitalization.
- Coordinate with nursing stations, wards, operation theatres, pharmacy, laboratories, radiology, and other departments to ensure services are captured accurately.
- Verify charges for room rent, procedures, investigations, professional services, consumables, and other applicable items.
- Review advance payments and outstanding balances and communicate discrepancies to the authorized supervisor.
- Coordinate the preparation of the final bill with the concerned departments before discharge.
- Ensure authorized discounts, concessions, refunds, and adjustments are supported by documented approvals.
- Complete billing formalities promptly while coordinating with the discharge team.

C. Insurance and corporate billing
- Verify insurance, corporate, and other eligible payer details as per hospital procedures.
- Coordinate preauthorization, cashless processing, claim documentation, and billing queries with the insurance or TPA desk when assigned.
- Ensure bills and supporting documents are complete and consistent with approved payer requirements.
- Track pending approvals, deductions, queries, and outstanding claims.
- Escalate claim discrepancies or payer-related delays to the designated supervisor.
- Never guarantee claim approval or coverage unless confirmed by the authorized payer.

D. Cash handling and financial controls
- Receive payments through approved modes, including cash, cards, UPI, and other authorized payment channels.
- Maintain accurate records of collections, refunds, and payment transactions.
- Reconcile daily collections against system reports and payment receipts.
- Prepare shift-wise or daily cash handover statements as required.
- Report cash shortages, excess collections, duplicate payments, suspected fraud, or system discrepancies immediately.
- Follow cash-handling limits, segregation of duties, and finance department instructions.
- Never use personal accounts or unauthorized payment channels for hospital collections.

E. Patient service and communication
- Communicate politely and professionally with patients and attendants.
- Explain bills, deposits, package inclusions, exclusions,



and payment requirements within the staff member's authorized knowledge.
- Handle billing complaints patiently and refer disputes to the billing supervisor.
- Protect patient dignity and maintain confidentiality when discussing financial or medical information.
- Support elderly patients and persons requiring assistance at the billing counter.
- Coordinate with patient relations and other departments to resolve billing-related concerns.

F. System management and documentation
- Use the hospital information system (HIS), billing software, and authorized payment systems accurately.
- Maintain records of invoices, receipts, credit notes, refunds, concessions, and approved adjustments.
- Ensure all transactions are entered under the correct patient ID and account.
- Maintain supporting documents for audits and financial verification.
- Protect login credentials and never share system access with unauthorized persons.
- Report billing software errors, duplicate entries, downtime, and access-control concerns to the appropriate team.

G. Compliance and quality improvement
- Follow hospital policies relating to billing, finance, patient rights, confidentiality, and record retention.
- Comply with applicable statutory requirements and approved hospital financial procedures.
- Cooperate with internal audits, external audits, and quality assessments.
- Participate in billing-related training and process-improvement initiatives.
- Report incidents, suspected irregularities, and process deviations through established channels.

1. Educational qualifications and experience

Requirement

Details

Minimum qualification

B.Com., BBA, B.Com. Computer Applications, or another qualification accepted by the hospital

Preferred experience

1–3 years in hospital billing, healthcare finance, cash collection, or a similar role

Computer skills

MS Excel, billing software, HIS, email, and basic data entry

Financial skills

Arithmetic, cash reconciliation, invoice verification, and payment processing

Communication

Valuable verbal communication in Tamil and English; additional languages as required

Preferred knowledge

Hospital tariffs, insurance/TPA processes, corporate billing, and patient service

Freshers may be considered for trainee billing positions if they meet the hospital's qualification and competency requirements.

1. Key Result Areas (KRAs) and Key Performance Indicators (KPIs)

The following are suggested indicators. Final targets should be approved by hospital management and adjusted to the assigned billing function.

KRA

KPI / performance measure

Suggested target

Billing accuracy

Correct bills without avoidable errors

≥ 99%

Billing turnaround time

Bills completed within the approved service timeline

≥ 95%

Cash reconciliation





Daily collections reconciled and handed over correctly

100%

Receipt compliance

Payments supported by authorized receipts

100%

Tariff compliance

Charges consistent with approved tariffs

100% compliance in audited transactions

Discharge billing

Final bills prepared within the defined departmental timeline

≥ 95%

Insurance documentation

Assigned billing documents completed accurately

≥ 98%

Complaint resolution

Billing complaints addressed or escalated within the service standard

≥ 95%

Documentation

Required billing records maintained and retrievable

≥ 98%

Training compliance

Mandatory training completed

100%

Targets should be monitored using documented audit samples, system reports, and defined measurement periods. Critical financial or patient-safety incidents must be escalated regardless of KPI performance.

1. Authority and limitations

The Billing Executive is authorized to:
- Generate bills and receipts for services supported by authorized entries.
- Collect payments through approved channels.
- Explain billing particulars and approved tariffs.
- Escalate discrepancies and request corrections through established procedures.

The Billing Executive is not authorized to:
- Approve unauthorized discounts, waivers, refunds, or write-offs.
- Change approved tariffs or package rates independently.
- Alter clinical orders, medical records, or service entries without authorized correction.
- Delete or suppress transactions to conceal discrepancies.
- Share patient information with unauthorized persons.
- Make independent decisions on medical necessity, insurance eligibility, or claim approval.

1. Working conditions and responsibilities

- Work in assigned OPD, IPD, emergency, discharge, insurance, or central billing areas.
- Perform rotational shifts, weekends, or holidays as per hospital requirements.
- Maintain accuracy during peak patient volumes and shift handovers.
- Handle cash and confidential information responsibly.
- Coordinate with clinical, administrative, and finance teams.
- Comply with the hospital's code of conduct and attendance requirements.

1. Reporting structure

Finance Manager / Billing Manager Billing Supervisor / Team Leader

Billing Executive / Billing Staff

1. NABH-oriented HR documentation

For implementation at GEM Hospital, maintain the following records as applicable to the role:
- Approved with document number, version, and effective date.
- Qualification and employment verification records.
- Induction and orientation checklist.
- Billing software and HIS competency assessment.
- Cash handling, billing accuracy, patient rights, confidentiality, and customer-service training records.
- Performance appraisal linked to approved KRAs and KPIs.
- Attendance and competency records.
- Periodic job-description review and employee acknowledgement.

These records support HR governance and audit readiness. The hospital should verify the final documentation against its current applicable NABH standards and controlled policies. Pay: ₹15,000.00 - ₹20,000.00 per hour

Benefits

- Provident Fund

Work Location: In person

📌 Billing staff (Ramanathapuram)
🏢 GEM HOSPITAL
📍 Ramanathapuram