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1. Job Summary

The Senior Executive – Credit Billing is responsible for managing inpatient credit billing operations, including insurance, TPA, corporate, government health schemes, and other approved credit patients. The role ensures accurate bill preparation, timely submission of claims, coordination for pre-authorizations and discharge approvals, monitoring of outstanding accounts, and timely resolution of billing discrepancies to support effective revenue cycle management.

1. Key ResponsibilitiesA. IPD Credit Billing Operations

- Manage end-to-end credit billing for inpatient admissions under insurance, TPA, corporate, and government health schemes.

- Verify patient eligibility, policy details, corporate agreements, coverage limits, and applicable billing tariffs.

- Ensure accurate capture of room charges, consultation fees, procedures, investigations, pharmacy, consumables, and other inpatient services.

- Review interim and final bills to ensure all services are accurately charged as per hospital policies and payer agreements.

- Verify package rates, inclusions, exclusions, and approved discounts before final bill submission.

- Ensure timely preparation and closure of inpatient credit bills during discharge.

B. Insurance, TPA &

- Corporate Coordination

- Coordinate with insurance companies and TPAs for pre-authorization, enhancement approvals, and final discharge approvals.

- Follow up on pending approvals and ensure required medical and billing documentation is available.

- Coordinate with corporate clients and government scheme authorities regarding billing requirements and claim processing.

- Ensure adherence to payer-specific billing guidelines, agreed tariffs, and documentation requirements.

- Communicate deductions,



non-payable items, co-payments, and patient liabilities to the concerned teams and patients.

C.

Discharge

Billing &

- Settlement

- Coordinate with IPD, nursing, medical records, pharmacy, and insurance teams to facilitate timely discharge billing.

- Review final bills and reconcile them against approved authorization amounts.

- Ensure patient-payable amounts, deposits, co-payments, and non-covered expenses are calculated accurately.

- Obtain necessary approvals for discounts, write-offs, and billing adjustments as per hospital policy.

- Ensure timely bill closure and submission of discharge-related documents to the respective payer.

D.

Claims

Documentation &

- Submission

- Verify completeness of medical records, discharge summaries, investigation reports, prescriptions, authorization letters, and supporting bills.

- Prepare and submit credit claims within prescribed timelines.

- Ensure accurate coding, tariff application, claim details, and supporting documentation, as applicable.

- Maintain records of submitted claims, pending documents, query responses, and claim status.

- Coordinate with medical records and clinical teams to obtain missing documentation.

E.

Outstanding

Follow-up &

- Denial Management

- Monitor outstanding credit bills and claims pending with insurance companies, TPAs, corporates, and government schemes.

- Follow up on delayed payments, short settlements, rejected claims, and deductions.

- Analyze claim rejections and deductions, identify root causes, and coordinate corrective actions.

- Prepare and submit responses to payer queries within stipulated timelines.

- Escalate long-pending claims and high-value outstanding accounts to the reporting manager.

Pay: ₹30,000.00 - ₹35,000.00 per month

Work Location: In person

📌 Credit Billing - Senior Executive (Banjara Hills)
🏢 Care Hospitals
📍 Banjara Hills