Role & responsibilities

1. Billing Operations Management • Supervise and manage all OPD, IPD, diagnostic and procedure billing processes. • Ensure accuracy and transparency in patient billing. • Monitor billing systems and ensure proper use of the Hospital Information System (HIS). • Review and approve final bills for discharge patients when required. 2. TPA & Insurance Management • Manage the hospitals insurance and TPA desk operations. • Ensure timely pre-authorisations, approvals and claim submissions. • Coordinate with insurance companies and TPAs for claim settlements. • Handle escalations related to claim rejections, delays or disputes. 3. Policy & Process Implementation • Develop and implement billing and insurance policies and procedures. • Ensure compliance with hospital policies, insurance guidelines and regulatory requirements. • Standardise billing practices and package rates for different procedures. 4. Team Management • Lead and supervise the billing executives, TPA executives and cashiers. • Provide training and guidance on billing procedures, insurance policies and documentation requirements. • Monitor staff performance and ensure effective workflow in the department. 5. Financial Monitoring & Reporting • Monitor daily revenue, billing reports and insurance claims status.



• Analyse billing data and identify areas for improvement or revenue optimisation. • Prepare financial and operational reports for hospital management. 6. Coordination with Hospital Departments • Coordinate with doctors, nursing staff, pharmacy, diagnostics and MRD for accurate billing and documentation. • Ensure all services provided to patients are properly recorded and billed. 7. Patient & Corporate Relations • Address patient concerns related to billing and insurance claims. • Manage corporate tie-ups and insurance empanelments. • Ensure smooth communication between patients and insurance providers

Preferred candidate profile Any graduate. • 1015 years of experience in hospital billing and insurance / TPA operations, including leadership of a billing team. • Experience leading billing executives, TPA executives and cashiers.

Billing accuracy and transparency across OPD, IPD, diagnostic and procedure billing.

- Timeliness of pre-authorisations, approvals and claim submissions; claim settlement turnaround.
- Claim rejections, delays and disputes resolution and escalation handling.
- Daily revenue, billing and claims reporting; revenue optimisation outcomes.
- Compliance with hospital policies, insurance guidelines and regulatory requirements.
- Team performance, and strength of corporate tie-ups and insurance empanelments.

📌 Head Billing and TPA (Mumbai)
🏢 WOW Softech
📍 Mumbai