Billing Manager

The Manager Billing Head will oversee and manage the hospital's billing and revenue cycle management processes to ensure accuracy, compliance, and efficiency. The role involves developing and implementing billing policies, maintaining smooth operational workflows, ensuring revenue realization, and leading a team to deliver high standards of performance in the billing department.

Key Responsibilities

1. Billing Operations Management
   
• Oversee and manage end-to-end patient billing processes, including inpatient, outpatient, emergency, and procedural services.
• Ensure accuracy in billing and timely generation of invoices for all patient categories (insurance, corporate, cash, and government schemes).
• Monitor collections, outstanding payments, and timely closure of revenue cycle processes.

2. Revenue Cycle Management (RCM)

• Design and implement efficient billing workflows to maximize revenue realization and minimize discrepancies.
• Identify gaps in the billing process, suggest process improvements, and implement automation wherever possible.
• Manage the reconciliation of revenue, receivables, and ensure alignment with financial records.

3.Compliance & Policy Implementation

• Ensure adherence to statutory and regulatory guidelines for billing in the healthcare industry.
• Monitor compliance with TPA/Insurance/Corporate agreements and government health schemes.
• Address audit observations related to billing and implement corrective actions as required.

4.Team Leadership

• Lead, mentor, and train the billing team to maintain high performance and efficiency.
• Define KPIs for the team and track performance regularly.
• Foster a collaborative working environment to resolve patient billing concerns promptly and effectively.

5.Patient and Stakeholder Management

• Handle escalations and queries related to billing discrepancies, refunds, and approvals.
• Build and maintain strong relationships with insurance companies, TPAs, and other stakeholders.
• Coordinate with medical, nursing, and other departments for seamless billing processes.

6.Data Analytics and Reporting

• Prepare and analyze monthly, quarterly, and annual billing reports for management.
• Conduct trend analysis to identify revenue opportunities and areas of improvement.
• Monitor billing KPIs such as collection ratio, billing accuracy, TAT for claim processing, etc.

7.Technology & Systems Integration

• Oversee the implementation and maintenance of billing systems, including HIS (Hospital Information Systems).
• Identify and address system issues that affect billing processes.
• Suggest and implement technological improvements to enhance billing efficiency.

Key Skills & Competencies

• In-depth knowledge of billing processes in the healthcare industry.
• Strong leadership and team management abilities.
• Excellent problem-solving and decision-making skills.
• Expertise in revenue cycle management (RCM) and regulatory compliance.
• Proficiency in using Hospital Information Systems (HIS) and financial software.
• Strong analytical and reporting skills.
• Exceptional communication and stakeholder management abilities.

Educational Qualifications

• Bachelor's/Masters degree in Commerce, Finance, Business Administration, or related fields.
• Certification in Revenue Cycle Management or Hospital Administration is an added advantage.

Experience Required

• 10-15 years of experience in billing and revenue management, preferably in a hospital or healthcare organization.
• At least 5 years in a managerial or leadership role.

Preferred Candidate Profile

• Candidates with a proven track record in handling large-scale billing operations in multispecialty hospitals.
• Experience in working with TPAs, insurance companies, and government health schemes.
• Proactive, detail-oriented, and results-driven professionals.

Perks and Benefits

• Competitive salary package
• Performance-based incentives
• Opportunity for career growth and development
• Health insurance and other employee benefits