Ip Billing Executive/ Senior Executive

2 weeks ago

Bengaluru, Karnataka, India Apollo Health and Lifestyle (AHLL) Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Key Responsibilities

Inpatient Billing Operations

  • Prepare and finalize inpatient bills with 100% accuracy.
  • Monitor and update provisional bills daily for admitted patients.
  • Post all charges (consultation, procedures, pharmacy, diagnostics, room rent, consumables, etc.) correctly.
  • Ensure billing adherence to hospital tariffs, package policies, and inclusions/exclusions.

TPA/Insurance Coordination

  • Handle admission intimation and obtain pre-authorization from TPAs/insurance companies.
  • Submit necessary documents (admission notes, investigations, treatment plans) to insurance/TPAs on time.
  • Track and follow up on approvals, enhancements, and extensions for continued stay.
  • Align final billing strictly as per TPA/insurance approval limits and policy guidelines.
  • Resolve TPA-related billing discrepancies with proper documentation.
  • Coordinate with consultants for timely discharge summary, medical records, and required justification for claim approvals.
  • Ensure discharge is processed only after receipt of TPA final approval/guarantee of payment.

Patient Interaction & Support

  • Counsel patients/attendants on billing and insurance queries.
  • Share cost estimates and provisional updates transparently during hospitalization.
  • Provide clarity on insurance coverage, co-payments, and exclusions.

Audit, Compliance & Reporting

  • Reconcile daily billing and insurance transactions.
  • Maintain accurate billing and insurance records for audits.
  • Ensure compliance with NABH/JCI and hospital billing guidelines.
  • Prepare periodic MIS reports on IP billing, TPA receivables, and claim status.

Team & Process Management

  • Support and guide junior billing/TPA staff.
  • Identify gaps in billing/TPA processes and suggest improvements.
  • Escalate unresolved cases to Billing Manager for timely closure.

Key Skills & Competencies

  • Strong knowledge of hospital IP billing & TPA/insurance processes.
  • Proficiency in Hospital Information Systems (HIS) and billing software.
  • Good communication, negotiation, and counseling skills.
  • Detail-oriented with strong numerical and analytical ability.
  • Ability to handle billing disputes diplomatically under pressure.

Qualification & Experience

  • Graduate in Commerce / Finance / Hospital Administration (MBA preferred).
  • 47 years of experience in hospital IP billing and TPA operations.
  • Hands-on experience in insurance/TPA pre-authorization, approvals, and claims mandatory.

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