Billing Executive

2 weeks ago

Manjalpur Vadodara Gujarat, India SWAJAN BANKERS Full time ₹ 2,50,000 - ₹ 6,00,000 per year
  • Beneficiary identification and verification:
  • Use the Beneficiary Identification System (BIS) and other relevant databases (SECC, RSBY, State Health Scheme) to check if a patient is eligible for the scheme.
  • Verify the patient's identity using an Aadhaar card or other government-approved ID, and confirm family details via a ration card or PMJAY ID.
  • Pre-authorization and treatment:
  • Prepare and submit a request for pre-authorization to the State Health Agency (SHA) or insurance company for planned medical procedures and diagnostics.
  • Coordinate with the hospital's medical team to gather the necessary documentation for the treatment package.
  • Claims management and billing:
  • Capture and record patient data on admission, treatment, and discharge using the Transaction Management System (TMS).
  • Process and generate the final patient bill according to the PMJAY-mandated packages and rates.
  • Ensure all necessary clinical notes, diagnostic reports, and discharge summaries are collected for claim submission.
  • Submit the claim on the official portal within 24 hours of the patient's discharge.
  • Patient support and coordination:
  • Act as a key contact point for PMJAY beneficiaries, guiding them through the registration and claims process.
  • Serve at the hospital's Ayushman Bharat kiosk to provide assistance and information to patients and their families.
  • Compliance and reporting:
  • Ensure all billing and claims activities are compliant with National Health Authority (NHA) guidelines.
  • Prevent and identify fraudulent or erroneous claims.
  • Help maintain accurate records and generate management information system (MIS) reports as required.

Job Type: Full-time

Pay: ₹10, ₹25,000.00 per month

Work Location: In person

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