Medical Billing Executive

Key Responsibilities1. Patient Billing OperationsGenerate accurate bills for OPD, daycare chemotherapy, immunotherapy, targeted therapy, supportive care, procedures, investigations, and pharmacy items.     Ensure correct mapping of services, consumables, drugs, and professional charges as per approved rate lists.Prepare interim, final, and discharge bills as applicable.     Explain bills clearly to patients/attendants and address billing-related queries politely and professionally.Insurance, TPA \& Corporate BillingVerify insurance eligibility, policy coverage, sub-limits, exclusions, and waiting periods.     Coordinate pre-authorization requests with TPAs/insurance companies, including documentation and timely follow-ups.Ensure billing strictly adheres to approved GIPSA/TPA rate lists and negotiated corporate rates.     Prepare and submit claims with complete documentation within defined TAT.Track claim status, respond to queries, and follow up for approvals, enhancements, and settlements.     Identify discrepancies in settlement letters and escalate for resolution.      Cash \& Credit ManagementCollect payments via cash, card, UPI, bank transfer, or cheque as per hospital policy.     Issue receipts and ensure proper daily cash reconciliation.Coordinate with accounts for deposit of collections and daily MIS reporting.     Maintain transparency and prevent underbilling, overbilling, or duplication of charges.. Coordination with Clinical \& Support TeamsCoordinate closely with doctors, nurses, pharmacy, lab, and front desk to ensure all billable services are captured.     Validate chemotherapy protocols, drug dosages, cycles, and consumables before billing.Ensure real-time updates of additional orders or changes in treatment plans.5. Documentation \& Compliance     Maintain complete patient billing files (physical and/or digital) with consent forms, approvals, case sheets, and investigation reports.Ensure compliance with NABH standards (if applicable), insurance norms, and internal SOPs.     Maintain confidentiality of patient data as per ethical and legal requirements.Reporting \& MISPrepare daily billing reports, collection summaries, pending approvals, and outstanding claims.     Maintain aging reports for receivables and follow up for timely recovery.Share monthly billing performance data with management.7. Audit \& Process Improvement     Support internal and external audits related to billing and insurance claims.Identify revenue leakages, process gaps, or recurring claim rejections.     Suggest improvements in billing workflows and documentation.Skills \& CompetenciesTechnical SkillsStrong knowledge of hospital billing processes, insurance, TPAs, and oncology-specific billing.     Familiarity with GIPSA rates, CGHS (preferred), and corporate health insurance processes.Proficiency in hospital management systems (HIS), MS Excel, and basic accounting software.Behavioral Skills     High attention to detail and accuracy.Ethical mindset and integrity in financial dealings.     Good communication skills (Hindi \& English; local language preferred).Ability to handle sensitive patient interactions with empathy.     Ability to work under pressure and manage multiple cases simultaneously.Educational QualificationsGraduate in Commerce / Business Administration / Healthcare Management (preferred).     Diploma or certification in Medical Billing / Hospital Administration is an added advantage.Experience Requirements1–5 years of experience in hospital or healthcare billing.     Prior experience in oncology, day care centres, or insurance-heavy setups preferred.Key Performance Indicators (KPIs)Accuracy of billing (minimal errors or rework).     Timely submission and settlement of insurance claims.Reduction in claim rejections and discrepancies.     Daily cash and billing reconciliation accuracy.Patient satisfaction related to billing clarity.Working Conditions     Hospital / cancer centre environment.Shift-based work may be required depending on patient load.     Interaction with patients, attendants, TPAs, insurance companies, and internal teams.

Pay

₹30,000.00 - ₹40,000.00 per month

Work Location

In person