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Engaged Employer

Health Care Global Enterprises

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4.2

based on 1.2k Reviews

1 Health Care Global Enterprises Head Job

Head - Billing

Health Care Global Enterprises

4.2

based on 1.2k Reviews

5-8 years

Visakhapatnam

1 vacancy

Head - Billing

Health Care Global Enterprises

posted 25d ago

Job Role Insights

Flexible timing

Key skills for the job

Medical Billing Claims Adjudication Claims Processing Revenue Management Invoicing

Job Description

Overall Supervision and functioning of the department to deal with billing clarifications with respect to Cash, TPA, corporate. Ensure staff training in billing & Billing audit Policy. Improve processes to achieve quick and error free billing.
Ensure all the services provided in hospital are mapped in HIS with their tariff as per bed category and payer category .
Ensure that the admission deposit is collected as per policy at the time of admission
Ensure that the surgeries are proceeded only after collection of OT clearance amount
Ensure that the services provided to patients are posted in HIS on regular basis
The respective stakeholders are informed regarding pending service posting and ensure the same is completed within 12 hours of informing
Ensure the OT billing is closed within 4 hours of surgery completion.
In case of items where GRN is pending, ensure that the OT billing is closed within 24 hours of surgery completion
Ensure that all the patients leaves the hospital only after paying complete bill and bill closure in HIS and discharge clearance is issued to all the patients
In case the service is not available in HIS and has been posted as "Unlisted services", the new service request is created as per Service Code creation SOPs. The billing manager has to ensure that no service is posted under Open billing without their approval
Keep track of Open bills of discharged patients and get them closed within 24 hours
In case of credit/corporate patients, the bill must be closed after receiving Final authorization from the TPA/insurance company and clearing the patient payable amount from the patient
Ensure that the required Document are sent as soon as possible and any query is resolved within 24 hours
Ensure the staff, clinicians and their next of kin are given discounts as per policy
Authorize the discounts as per policy for cash patients and ensure that the discount remarks are entered properly in HIS
Ensure the discount approvals are taken in designated forms and authorization is taken from respective authorities as per policy. The scanned copies of forms are uploaded in HIS for future reference.
Authorize the bill cancellations due to billing error, admission cancellation or any other reasons. Document the same in HIS under reason for cancellation
Ensure the refund is processed within 24 hours of bill cancellation
Ensure that the Daily monitoring of bill status and collection of outstanding is done without failure
Ensure that 100% of the bills are audited before closing the bills.
Review the weekly Score cards for Wards, Billing, Credit cell & Credit control
Analise the reasons for poor performing parameters and plan for improvement
Keep track of out standings cleared from Corporate, TPA and Govt schemes and accordingly get it closed in TCS
Audit minimum 10% of IPD discharge files.