Clerk (Billing / TPA)

FRONT OFFICE

· To attend enquiry about TPA/Insurance Company and to give information to patient relatives.

· To counseling patient family and pre-auth process

· To send pre-authorization form via mail/ on portal to concern TPA

· Maintaining & uploading patient’s files on the portal.

· Couriering the hard copy of patient’s medical documents to the insurance companies.

· Co-ordination activities from patient’s admission to discharge & hospital staff.

· Handling all TPA portals

· Outstanding follow-up with TPA

· To obtain and review referrals and authorizations for treatments

· Co-ordinate with Nobel for medicine bills

· Scan noble medicine and medical bills on daily basis (min 50-max 150 papers)

· To intimate patient to pay difference of bill and final approval amount to billing counter

· Follow up with concerned floor RMO for correct documentation query reply to TPA

· Cashless not utilized reply mail to concern TPA / Insurance Company.

· To reply to day to day repeated query email raised by TPA during admission of patient.

· Apply scheme difference of patient (min 20-max 30 TPA patients daily)

· Update admission status of the patients as per the changing additional approvals.

· To scan final bill, medicine bills, all IPD case papers (min 100-max 500 papers as per patients query) for uploading on portal and to get final approval letter from TPA /Insurance Company

· Checking every patients documents such as reports, final bills, approval letters, covering letters, medicine bills and discharge summaries for the dispatch process.

· Preparation of final bill

BACK OFFICE

· To check mail for payment received from TPA company via NEFT in bank account.

· On 1st day of every month to take print out from Carework System for unsettled IPD & OPD bills register and to maintain the updated record as the system does not give backdated data as it is.

· Settlement of TPA bill payment received from credit company and to post credit voucher in Careworks and to send deposit applied slip to billing department for further process of refund to TPA patient.

· Preparation of age wise TPA outstanding for management information.

· To assist administration department for TPA empanelment.

· To follow up with TPA for long /short outstanding payment via mail.

· To intimate TPA company via mail about updation/revision of schedule of charges.

Job Types: Full-time, Contractual / Temporary

Pay: ₹20,000.00 - ₹30,000.00 per month

Work Location: In person