MIS & Control Executive

3 days ago

Mumbai, Maharashtra, India Kokilaben Dhirubhai Ambani Hospital Full time ₹ 8,00,000 - ₹ 12,00,000 per year

Role & responsibilities

1. Revenue assurance: -

  • 100% checking of OT and Cath lab procedures,
  • To plug in missed / partial charging of bed side procedures / doctor referral charging based on visit note etc,
  • Patient charging items consumed in A&E, Dialysis unit, Endoscopy etc,
  • All surgical and medical bills to be checked for bed class, patient movement bed category wise and charging of services accordingly, payer checking, consumable charging including implants, if any etc,
  • Any request for upgradation should have proper written authorization from the management,
  • To check estimate vs actual and find out department / Doctor where variation is more than 30%,
  • All high outstanding / long stay bills to be audited and communicated to patient on timely manner. Ensure their queries are replied on a timely manner,
  • Package inclusions and exclusions to be checked for all common packages billed and ensure inclusions as per defined tariff,
  • Rates to be checked for all high-end investigations / procedures and to ensure it matches with agreed tie up rates,
  • Equipment / Appliance charging in OT. To ensure equipment used in the surgery is billed without any exceptions,
  • To check estimate for surgical and medical admission,

  • To check files send to various TPA/Corporate with regard to correctness of rate, completeness of documentation, timely submission etc

  • Consumables: -

  • Process of charging of consumables in Ots

  • OT To check Discarding policy on high value items such as octopus, stapler, harmonic, Guns etc
  • Control related to consignment items in OT, Instruments provided by vendor on loan basis, RTV to vendors etc
  • To check Package wise consumption,
  • Departmental consumption. Month on month consumption analysis and reasons for major variance. Check items. Patient charging items should not be booked as consumption,
  • To check and validate the process of Reuse items such as Octopus, Liga sure, Harmonic, Gastro items such as Dilatation balloon/extractors/Catheters/Snares etc,
  • To check margin on items, charging policy i.e. whether MRP or cost plus mark up
  • Vendor negotiation - Identify items that need re-negotiations
  • Packages Least cost items

  • Other points such as Ala-carte – highest margin items, Implant margin etc

  • Cost controls: -

  • Printing and Stationery - Feasibility of inhouse v/s Rental of Cartage, Paper cost

  • Reagent and other consumption in lab,
  • Laundry Vendor
  • Vehicle hire charges - Feasibility of Own v/s monthly hiring v/s Daily hiring
  • Other non-medical consumable including HK Consumables
  • Various vendors of Repairs & Maintenance
  • Travelling exp,

4. Other Audit areas:-

  • CSSD audit,
  • A & E audit,
  • Daycare unit such dialysis, Chemotherapy, Endoscopy area audit,
  • Regular surprise physical verification at various stores and sub-stores of the hospital,
  • Audit of special management discount given on IP/OP bills, Refund, Cancellation etc.

Preferred candidate profile

  • Accountability
  • Interpersonal skills
  • Computer skills
  • Audit
  • Any graduate with 4 to 8 years of experience in MIS Audit & Control

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