A Senior Executive – Billing is responsible for overseeing end-to-end hospital billing operations, ensuring accurate bill generation, timely discharge billing, insurance and TPA coordination, and efficient revenue cycle management. The role involves monitoring patient billing activities, validating billing documents, coordinating with clinical and non-clinical departments, managing insurance pre-authorisations and claim submissions, resolving billing discrepancies, monitoring accounts receivable, and minimising claim denials. The position also ensures compliance with hospital billing protocols, payer guidelines, and applicable healthcare regulations while maintaining billing accuracy, operational efficiency, and patient satisfaction.
Interested can share resumes to [email protected] or whats app your profile to 6360986847
Discharge Billing: Oversee final bill preparation, verification of hospital charges, package inclusions and exclusions, pharmacy and diagnostic charges, deposits, and adjustments to facilitate timely patient discharge.
Insurance and TPA Coordination: Manage insurance and TPA billing processes, including pre-authorisation, cashless approvals, claim submission, documentation, query resolution, and follow-up on pending, rejected, or denied claims.
Revenue Cycle and Receivables Management: Monitor billing collections, outstanding payments, accounts receivable, and pending insurance claims to minimise revenue leakage and improve collection efficiency.
Billing Audit and Reconciliation: Review patient bills, verify charge accuracy, identify billing discrepancies, and reconcile hospital services, payments, discounts, refunds, and adjustments in accordance with approved policies.
Interdepartmental Coordination: Coordinate with clinical departments, nursing, pharmacy, diagnostics, medical records, front office, and finance to ensure accurate billing, timely charge capture, and smooth discharge processes.
Patient and Payer Query Resolution: Handle escalated billing queries and disputes professionally, coordinating with patients, attendants, insurance companies, and TPAs to ensure timely resolution.
MIS and Performance Reporting: Prepare and analyse daily, weekly, and monthly billing reports, collection statements, outstanding reports, claim ageing reports, and other management information system (MIS) reports.
Compliance and Documentation: Ensure adherence to hospital billing protocols, approved tariff structures, insurance and TPA guidelines, documentation standards, and applicable regulatory requirements; support internal audits and insurance audits.
Process Improvement and Operational Support: Identify recurring billing errors, recommend corrective actions, support implementation of standard operating procedures (SOPs), and contribute to improved billing accuracy, turnaround time, and revenue cycle efficiency.
Education: Bachelor’s degree in Healthcare Administration, Hospital Management, Finance, Commerce, or a related field.
Experience: Minimum 4–5 years of experience in hospital billing operations, preferably in a multispecialty or super-specialty hospital.
Technical Skills: Proficiency in Hospital Information Systems (HIS), billing and revenue cycle management software, and MS Excel.
Domain Knowledge: Strong understanding of inpatient (IP) and outpatient (OP) billing, discharge billing, insurance and TPA claims processing, pre-authorisation, claim reconciliation, and accounts receivable management.
Compliance Knowledge: Familiarity with hospital billing policies, insurance payer guidelines, and applicable healthcare regulations.
Core Competencies: Strong analytical and problem-solving skills, attention to detail, effective communication, coordination with clinical and non-clinical departments, and the ability to manage billing discrepancies and claim denials efficiently.