Job Description

The Ayushman Executive will be responsible for the overall coordination, execution, and compliance of the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme within the hospital. The role involves managing patient enrollments, ensuring proper documentation and approvals, handling claim processing, and liaising with government portals and authorities to ensure smooth functioning of the scheme.

Key Responsibilities

Scheme Implementation:

Ensure smooth and effective implementation of the Ayushman Bharat scheme at the hospital level.

Patient Enrollment:

Guide eligible patients through the Ayushman registration process, ensuring all required documentation is collected and uploaded accurately.

Authorization & Claim Management:

Submit pre-authorizations and final claims on the BIS/PM-JAY portal. Follow up on claim approvals and rejections.

Portal Management:

Maintain regular updates and entries in the Ayushman Bharat portal. Ensure real-time data accuracy and error-free entries.

Coordination:

Liaise with the medical team, billing, and IT departments to coordinate approvals, admissions, and discharges under the scheme.

Compliance & Audits:

Ensure all Ayushman-related documentation is maintained as per government norms. Prepare for audits and inspections.

Reporting:

Generate and maintain MIS reports related to Ayushman admissions, claims, payments received, and rejections.

Training & Support:

Train supporting staff on the process and updates related to PM-JAY. Assist in troubleshooting any issues.

Grievance Handling:

Address patient or family concerns related to scheme eligibility or claim rejections and provide timely resolutions.

Qualifications & Skills

Education:

Graduate or Postgraduate in Healthcare Management, Public Health, or related field.

Experience:

1-3 years of experience in handling government health schemes (Ayushman Bharat preferred) in a hospital setting.

Tech Skills:

Proficiency in using Ayushman Bharat BIS/PM-JAY portal and MS Excel.

Knowledge:

Good understanding of government health schemes, insurance claim workflows, and patient counseling.

Communication:

Strong interpersonal and communication skills to coordinate with internal teams and government authorities.

Compliance-Oriented:

Attention to detail and commitment to following rules and protocols.
Job Types: Full-time, Permanent

Pay: ₹12,000.00 - ₹15,000.00 per month

Benefits:

Flexible schedule Leave encashment
Work Location: In person