o On Admission Patient/attendant will be given financial counseling for their treatment expenses.
o Providing estimation/package for the patients who are advised for surgery (complicated/sensitive case). Estimation includes the detailed explanation to the patient/relatives on the packing inclusions and exclusions and also to ensure to collect the PKG amount on or before the Surgery.
o To involve and solve difficult payment associated business problems.
2. Billing Functional activities
o Develops and implements new procedures to improve the quality and quantity of work processed ensure policies are communicated and administered consistently.
o Monitors daily operating activity of department and makes necessary adjustments in work assignments.
o Providing interim bill updating to all the patients and to collect adequate advance deposits accordingly. This process includes the explanation on the billed amount to the patients/relatives. And to provide complete clarification/transparency to the patients on their billed amount ensuring the satisfaction and complete understanding of the patient.
3. IP Billing - discharge Process
o Ensuring the bill accuracy on the Final bill before the discharge. By doing Pre and Post audit on the finalized bills.
o Attending all the queries of the In-patients and their relatives or guest regarding the discharge and final bill amount in the hospital.
4. Insurance patient preauthorization process
o Ensuring all preauthorization filled properly with package/medical expenses
o Verifying the final claim submission to insurance with all blood investigation, radiology and relevant reports attached the claim to avoid the disallowance
o Ensuring all insurance claims dispatching within TAT period
o Monitoring and replying post discharge queries from the TPA'S/ Insurance
o Following up of insurance payment
5. Master Tariff Updating
o New tariff updating, preparing new packages and periodical revision of the master tariff as per the instruction of the management/unit head.
6. Leadership & Supervision:
o Lead, supervise, and mentor the billing team to ensure efficient, accurate, and timely billing operations.
o Monitor team performance, provide coaching, conduct regular performance evaluations, and implement professional development opportunities.
o Ensure that the billing team adheres to all organizational policies and industry standards.
7. Compliance & Documentation:
o Ensure compliance with healthcare billing regulations, including HIPAA, Medicare/Medicaid, and commercial payer requirements.
o Stay up-to-date with healthcare billing laws and coding changes (e.g., ICD-10, CPT, and HCPCS) and ensure accurate implementation.
o Maintain accurate records of billing activities, payments, adjustments, and refunds, ensuring proper documentation for audits.
8. Financial Reporting & Analysis:
o Analyze billing and accounts receivable data to identify trends, improve efficiency, and maximize revenue recovery.
o Prepare regular reports for senior management on billing performance, cash flow, and outstanding accounts.
o Recommend process improvements to enhance billing accuracy, minimize denials, and reduce days in accounts receivable.
o Monthly MIS report sharing with the management.
9. Collaboration & Communication:
o Work closely with physicians, department heads, and clinical staff to ensure proper coding, charge capture, and accurate billing of services rendered.
o Serve as a liaison between the billing department and other healthcare departments to ensure seamless billing processes.
o Communicate with insurance companies to resolve claim issues, including denials and underpayments.
o Handle patient inquiries regarding bills, insurance, and payments, providing excellent customer service and resolving issues efficiently.
10. Training & Process Improvement:
o Train new and existing billing staff on billing systems, coding practices, payer policies, and any other relevant billing procedures.
o Continuously assess billing processes and recommend enhancements or changes to improve overall revenue cycle performance.
o Implement strategies to reduce claim denials, optimize payment posting, and improve collections.
Any other duties assigned to them by the management from time to time.
Job Types: Full-time, Permanent
Pay: ?40,335.63 - ?70,431.50 per month
Benefits:
Provident Fund
Experience:
total work: 3 years (Preferred)
Work Location: In person
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