IP Billing Executive

Greetings form Rainbow Hospitals !!!!!

Job Summary: Responsible for maintaining revenue by establishing, implementing, and controlling billing system.

Receive payment from all patients for the hospital services provided.

• Submit all related documents like reports, bills and discharge summary to concerned internal departments for final approval and settlement
• Process all insurance TPAs and resolve their queries (TPAs as well as patients) to get the approval for payment clearance.
• Coordinating with TPA Network team regarding reconciliation, billing queries like, over billing justification/ PPN Package issues & resolving.
• Ensure transactions are correctly recorded of both OPD and IPD functions also maintaining the records & register for IPD.
• To check the accuracy of the bills on daily basis, before the same could be circulated to the patients/attendants.
• Responsible generation of daily reports & submitting the same to the manager.
• Responsible for cash & credit billing (Insurance) for in-patient department.
• Explaining the cash / TPA (Third Party Administration) insurance package to the patients and initiating backend process by sending all the insurance documents to the respected TPAs for the final settlement.
• Daily checking the insurance patients and discuss with their consultants about their treatments & stay of hospitalization.
• Daily Updating of Hospital Inpatient, census for pending payments, cashless/ approval status in TPA cases.
• Responsible for maintaining all TPAs (Third Party Administrator) data and MIS.
• To maintain a good relationship with TPAs for smooth functioning of the department.
• Interact with all the internal and external auditors and answer queries if any.
• Ensure all the documents are filled as per audit requirement and shared with the respective departments on a timely basis.
• Ensure timely resolution of patient queries (discounts/ billing/ packages etc.) and counsel them on insurance related matters if any.
• To co-ordinate with other departments like Pharmacy, OT Stores & Materials Stores for smooth flow of discharge process.
• To interact with cross function teams to receive/ share updates timely
• Any other portfolio that may be entrusted by the management from time to time.

Educational Qualifications: B.com/ MBA

Work Experience:

• 2+ years of experience in Billing Department.
• Good communication and interpersonal skills
• Accurate processing of information both verbal and written
• Demonstrates high attention to detail with ability to solve problems on hand
• Should demonstrate patience and confidence when dealing with customer enquiries and complaints
• Strong attention to details

Expected Deliverables:

• Ensuring zero billing discrepancies
• Accurate filing and maintenance of bills (online and offline)
• Timely processing of insurance claims with TPAs
• 100% compliance to statutory and internal audits
• Resolving customer queries and ensure zero escalations