Plunes is looking for an experienced Billing Executive with hands-on exposure to PMJAY (Ayushman Bharat) and other government health insurance schemes to manage claim billing and ensure timely, accurate settlements.
Location: Delhi
Experience: 1 Year in hospital or healthcare billing, with direct government scheme exposure
Must-Have Experience
Hands-on experience with PMJAY claim processing, pre-authorisation, and billing on the TMS/BIS portal
Working knowledge of other government health schemes such as ECHS, CGHS, CAPF, state government schemes, etc.
Understanding of package rates, claim documentation, and scheme-specific guidelines
Key Responsibilities
Prepare, verify, and submit claims under PMJAY and other government schemes
Handle pre-authorisations, queries, and rejections raised by scheme authorities
Ensure claim documentation is complete and compliant to reduce rejections and deductions
Track claim status and follow up on pending settlements and payments
Reconcile claims with payments received and maintain accurate MIS
Coordinate with hospitals, TPAs, and internal teams on billing and claim issues
Requirements
Graduate (B.Com / M.Com or related field preferred)
Proficiency in MS Excel and billing/HIS/accounting software
Solid attention to detail, with positive communication and follow-up skills
Ability to work to deadlines and handle high claim volumes
Positive to Have
Experience with private insurance/TPA billing
Familiarity with healthcare receivables or hospital revenue cycle management