Billing Executive

Position: Billing Executive

Experience: 2 years (Minimum), 5 years (Relevant/Additional)

Additional Exp.: Handling TPA portals, insurance coding, pre-authorization processes, and billing in a hospital setting. Proficiency in Hospital Information Systems. Experience of using Tally.

Location: Dahej

Skills: Communication, negotiation, documentation, persuasive ability, target orientation, strong interpersonal skills, listening and achievement orientation

Qualification: Graduate (B.Com) with knowledge of TPA operations and hospital billing

Language preferred: English, Hindi, Gujarati

To manage accurate patient billing, prepare estimates, process insurance claims, and coordinate with TPAs to ensure timely pre-authorizations and claim settlements Key Responsibilities:

Billing Responsibilities:

• Generate and maintain accurate inpatient and outpatient bills
• Post daily charges (consultation, procedures, diagnostics, pharmacy, etc into the Hospital Information System (HIS)
• Prepare provisional and final bills and ensure transparency in billing with patients and caregivers
• Collect payments (cash, card, online) and issue receipts
• Reconcile daily cash and billing reports with finance/accounts

TPA Coordination Responsibilities:

• Collect and verify patient insurance documents at the time of admission
• Generate and submit pre-authorization requests to TPAs and follow up for approval
• Communicate approvals, denials, and required clarifications to patients and billing teams
• Submit final bills, discharge summaries, and claim documents for settlement
• Track claim statuses and ensure timely collection of payments from TPAs

Communication & Support:

• Educate patients on billing details and insurance claim procedures
• Coordinate with doctors, nursing, and medical records departments for claim documentation
• Respond to queries from patients, TPAs, and internal departments professionally

Documentation & Compliance:

• Maintain patient billing files, pre-auth copies, and claim documents in proper order
• Ensure compliance with insurance norms, hospital SOPs, and data privacy regulations
• Participate in internal audits related to billing and TPA processing
• Other Relevant task assigned by senior authority

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