Please Note : Only Hospital Experience Candidate can apply.
Key Responsibilities
- Coordinate patient discharge with doctors, nursing staff, and billing department
- Prepare final bills at the time of discharge for cash and insurance patients
- Ensure completion of all discharge documentation
TPA & Insurance Handling
- Handle end-to-end TPA/insurance cases from admission to discharge
- Verify insurance eligibility, policy coverage, and exclusions
- Submit pre-authorization and enhancement requests to TPAs/insurers
- Follow up with TPAs/insurance companies for approvals and queries
Billing & Claims
- Prepare accurate bills as per TPA/insurance agreements and hospital tariffs
- Ensure correct coding and documentation as per insurer requirements
- Submit final claims within stipulated timelines
- Coordinate for claim settlements and resolve rejections or discrepancies
Documentation & Compliance
- Maintain complete and accurate patient billing records
- Ensure compliance with hospital policies, NABH standards, and insurance norms
- Keep track of pending claims, approvals, and settlements
Coordination & Communication
- Act as a liaison between patients, TPAs, insurance companies, doctors, and hospital staff
- Explain billing and insurance-related queries to patients and attendants
- Escalate issues related to delayed approvals or settlements
Required Qualifications
- Graduate in any discipline (preferred: Healthcare Management / Commerce)
- Certification or training in Medical Billing / TPA operations is an advantage
Experience
- 3–5 years of experience in hospital billing and TPA operations
- Experience in multi-specialty hospital preferred
Skills & Competencies
- Strong knowledge of TPA and insurance processes
- Good understanding of hospital billing systems and tariffs
- Excellent communication and coordination skills
- Attention to detail and accuracy
- Proficiency in hospital information systems (HIS) and MS Office
Key Performance Indicators (KPIs)
- Timely discharge processing
- Accuracy of billing and documentation
- Reduction in claim rejections
- Turnaround time for TPA approvals and settlements
Job Types: Full-time, Permanent
Pay: ₹200,633.21 - ₹300,000.00 per year
Benefits:
- Cell phone reimbursement
- Health insurance
- Provident Fund
Work Location: In person