OP Hospital Billing Executive

2 days ago

Chennai, Tamil Nadu, India Kauvery Hospital Full time ₹ 12,00,000 - ₹ 24,00,000 per year

Job Summary

The Outpatient (OP) Billing Executive is responsible for managing all aspects of outpatient billing, ensuring accuracy, efficiency, and compliance with hospital policies and standard billing procedures. The role involves coordinating with patients, doctors, and other hospital departments to facilitate a smooth billing process and provide excellent patient service.

Key Responsibilities Billing and Documentation:

  • Accurate Billing: Handle all outpatient billing activities, including consultations, diagnostics, and procedures, ensuring accurate and error-free billing.
  • Data Entry: Accurately enter patient information, treatment details, and charges into the Hospital Information System (HIS) or billing software.
  • Charge Updates: Ensure the system's tariff structure, including consultation and procedure charges, is current to prevent calculation errors.
  • Manual to Computerized Billing: Ensure all billing is done through the computer system and strictly avoid manual billing.
  • Reconciliation: Reconcile daily billing transactions and cash collections with the accounts department.

  • Insurance and Claims:

  • Verify patient insurance coverage and eligibility.

  • Handle the billing and processing of claims for patients covered under insurance, including schemes like CGHS/ECHS.

  • Follow standard operating procedures (SOPs) for submitting claims to insurance companies and clearing rejections.

  • Record Keeping: Maintain all billing documents and patient files in an organized and confidential manner, adhering to HIPAA and hospital regulations.

Patient Communication and Service:

  • Patient Inquiries: Address patient and attendant queries regarding billing procedures, charges, and payment options clearly and courteously.
  • Payment Collection: Collect payments for outpatient services, process receipts, and manage refunds and settlements.
  • Explanation of Bills: Before finalizing a bill, explain the complete breakdown of charges to the patient or attendant and take their acceptance.
  • Payment Follow-up: Track and follow up on any outstanding or delayed payments from patients or insurance companies.

Inter-departmental Coordination:

  • Collaboration: Coordinate with other departments such as the front office, pharmacy, and diagnostic labs to ensure all services rendered are included in the patient's bill.
  • Process Improvement: Identify and resolve billing discrepancies and investigate any errors to ensure timely payments and customer satisfaction.
  • Reporting: Prepare and submit periodic reports on billing and collection activities to the management.

Qualifications and Skills Education:

  • Any Graduate (Preferably in Finance, Accounting, or Healthcare Administration).
  • Certification in Medical Billing or Coding is an added advantage.

Experience:

  • 14 years of experience in hospital or healthcare billing, with specific exposure to OP billing.

Required Skills:

  • Proficiency in hospital billing software and Microsoft Office applications, especially Excel.
  • Strong knowledge of medical billing codes (ICD-10, CPT) and healthcare regulations.
  • Excellent communication and interpersonal skills to handle patients and internal teams.
  • Exceptional attention to detail and a high level of accuracy.
  • Strong analytical and problem-solving abilities to resolve billing issues.
  • Ability to work in a fast-paced environment and manage cash responsibly.
  • Demonstrated ability to maintain confidentiality with patient and financial records.

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