Cghs Billing

**Job Title**: CGHS Billing Coordinator
**Location**: Kharghar
**Department**: Billing
**Reports To**: Director

**Job Summary**:
The CGHS (Central Government Health Scheme) Billing Coordinator is responsible for managing and overseeing all billing activities related to CGHS patients, ensuring accurate and timely processing of claims, managing queries, and maintaining compliance with CGHS guidelines. This role is critical for ensuring the hospital’s revenue from government-funded patients is maximized through efficient billing and collections processes.

**Key Responsibilities**:

- **Billing & Claims Processing**:

- Process and submit CGHS-related claims accurately and within specified timeframes.
- Ensure all claims are complete with necessary supporting documents as per CGHS guidelines.
- Review and verify patient information, insurance coverage, and service details to ensure claim accuracy.
- **Compliance & Documentation**:

- Maintain thorough and up-to-date knowledge of CGHS policies and billing protocols.
- Ensure compliance with CGHS documentation standards for all submitted claims.
- Regularly audit claims to identify and rectify any discrepancies or errors.
- **Follow-up & Payment Reconciliation**:

- Track the status of submitted claims and follow up on any rejections or denials with CGHS authorities.
- Reconcile payments received with submitted claims to ensure all payments are accurately documented.
- Identify and address payment discrepancies in a timely manner.
- **Coordination & Communication**:

- Coordinate with the finance and accounts department to facilitate smooth revenue cycle management.
- Act as the point of contact for CGHS-related queries from patients, internal teams, and CGHS authorities.
- Keep patients and their families informed of any billing requirements or changes related to CGHS.
- **Reporting & Analytics**:

- Generate regular reports on CGHS billing performance, payment status, and outstanding amounts.
- Analyze claim rejection trends to identify areas for improvement and reduce the rejection rate.
- Provide insights and recommendations to the Billing Manager for optimizing CGHS billing processes.
- **Patient Assistance**:

- Assist patients in understanding their CGHS benefits, co-payments, and coverage limitations.
- Ensure patient satisfaction through timely and effective communication and issue resolution.

**Qualifications**:

- Bachelor’s degree in finance, healthcare administration, or a related field.
- 2+ years of experience in healthcare billing, preferably with CGHS or other government healthcare schemes.
- Strong knowledge of CGHS billing guidelines, policies, and procedures.
- Proficiency in billing software, Microsoft Office Suite (Excel, Word), and hospital management systems.
- Excellent communication and interpersonal skills.
- Strong analytical and problem-solving abilities.
- Detail-oriented with a commitment to accuracy and compliance.

**Preferred Qualifications**:

- Experience working in a hospital or healthcare facility handling government-funded billing.
- Knowledge of medical terminology and healthcare coding practices.

**Job Types**: Full-time, Part-time

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

Schedule:

- Day shift
- Evening shift
- Night shift
- Rotational shift
- Weekend availability

Work Location: In person