Billing Executive

4 weeks ago

Nagpur Maharashtra, India SWASTHYAM SUPERSPECIALITY HOSPITAL,NAGPUR Full time

The Billing Executive will oversee the accurate and timely processing of patient bills, including those for CGHS (Central Government Health Scheme), TPA (Third Party Administrators), corporate clients, and cash-paying patients. The role requires strong knowledge of hospital billing processes, excellent communication skills, and a commitment to delivering a seamless patient experience.

**Key Responsibilities**:
**1. CGHS Billing**:

- Process and manage billing for CGHS patients as per government guidelines.
- Verify eligibility, approval letters, and required documents for CGHS patients.
- Ensure compliance with CGHS tariff rates, codes, and billing formats.
- Coordinate with the accounts department for submission and follow-up of CGHS claims.

**2. TPA Billing**:

- Handle TPA billing processes, including pre-authorization, interim, and final billing.
- Liaise with TPA representatives to resolve queries and ensure approval of claims.
- Validate documents, approval letters, and required forms for accuracy.
- Ensure timely submission of claims and follow-ups for payments.

**3. Corporate Billing**:

- Prepare and process bills for patients covered under corporate tie-ups.
- Verify eligibility and coverage details from corporate agreements.
- Ensure adherence to agreed corporate tariff rates and billing policies.
- Maintain accurate records of corporate bills and facilitate smooth payment cycles.

**4. Cash Billing**:

- Generate bills for cash-paying patients in a timely and accurate manner.
- Explain billing details to patients and ensure proper receipt issuance.
- Handle adjustments, refunds, and escalations as required.

**5. General Billing Tasks**:

- Verify patient records, services, and consumables for accurate billing.
- Ensure compliance with hospital policies and regulatory requirements.
- Address patient or family queries regarding bills and clarify discrepancies.
- Coordinate with other departments (front office, insurance, accounts, etc.) to ensure a smooth billing workflow.

**6. Documentation and Reporting**:

- Maintain detailed records of all bills, receipts, and claims.
- Generate daily, weekly, and monthly billing reports for review.
- Assist in audits and reconcile billing discrepancies.

**Required Skills and Competencies**:

- Proficiency in hospital billing software and systems.
- Knowledge of CGHS guidelines, TPA processes, and corporate billing protocols.
- Excellent communication and interpersonal skills.
- Strong attention to detail and numerical accuracy.
- Ability to multitask and manage priorities in a fast-paced environment.

**Qualifications and Experience**:

- **Educational Qualification**: Bachelor's degree in commerce, healthcare administration, or a related field.
- **Experience**: 1-3 years in hospital billing, with exposure to CGHS, TPA, corporate, and cash billing processes.

Pay: ₹10,000.00 - ₹15,000.00 per month

Schedule:

- Day shift
- Evening shift
- Morning shift

**Education**:

- Bachelor's (required)

**Experience**:

- Billing: 1 year (required)

Shift availability:

- Day Shift (required)
- Night Shift (required)
- Overnight Shift (required)

Work Location: In person

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