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Medical Billing Specialist

1 week ago


Mumbai, Maharashtra, India Ravindra Pratap Gupta (Properitor Of RPG Ventures) Full time
Job Title: IPD/OPD Billing Executive

Location: Kandivali, Mumbai

Employment Type: Full-time

The role of the IPD/OPD Billing Executive is critical to the financial operations of the hospital. As a key member of the team, you will be responsible for ensuring accurate and timely billing of inpatient and outpatient services.

Main Responsibilities:
  1. Billing & Invoicing:

Billing Process: You will generate accurate bills for inpatient (IPD) and outpatient (OPD) services, including consultation fees, diagnostic tests, procedures, and medications. This involves verifying treatment details, doctor fees, service charges, and insurance approvals before finalizing bills.

  1. Coordination & Documentation:

You will coordinate with doctors, nurses, pharmacy, and laboratory teams to ensure proper billing of services rendered. Additionally, you will maintain and update patient records in the hospital billing system (HMS). Your responsibilities also include verifying insurance claims, approvals, and cashless transactions with TPA/insurance providers, as well as handling corporate and government scheme billing as per applicable guidelines.

  1. Patient Interaction & Support:

As an IPD/OPD Billing Executive, you will explain bills to patients and their attendants, resolving any queries related to charges. You will also assist patients in understanding insurance policies and reimbursement processes. Furthermore, you will ensure smooth discharge process by verifying outstanding payments and completing final settlement.

  1. Reporting & Compliance:

You will generate daily, weekly, and monthly billing reports for management review. It is essential to ensure billing adherence to hospital SOPs and regulatory guidelines. Any discrepancies in billing should be identified and reported, and suggestions for process improvements can be provided.

Requirements:

To succeed in this role, you should have 1-3 years of experience in hospital billing, preferably in IPD/OPD billing roles. Your technical skills should include proficiency in hospital billing, strong MS Excel skills for report generation and analysis, knowledge of insurance claim processing, and TPA coordination. Excellent communication and interpersonal skills are essential for interacting with patients and hospital staff. Problem-solving ability and attention to detail are also crucial for success in this position.