Billing Executive

Aakash Health Care; New Delhi; On-site; INR 250,000 - 450,000; Full time

Job summary

Aakash Hospital, Dwarka, is seeking an experienced Billing Executive Core Billing to manage end-to-end hospital billing with emphasis on IPD/Core, TPA, PSU, corporate panels, and final discharge billing.

The role requires practical knowledge of hospital tariffs, packages, TPA/Insurance processes, PSU and corporate panel requirements, cashless approvals, billing reconciliation, and ensuring accurate billing with minimal revenue leakage and timely final discharge clearance.

Qualifications

• 2–5 years of hospital billing experience.
• Hands-on experience in Core/IPD Billing and Final Discharge Billing.
• Familiarity with TPA/Insurance, PSU and corporate panels.

Responsibilities

• Handle IPD/Core Billing from admission to final discharge.
• Prepare and maintain interim and final patient bills.
• Verify tariffs, packages, discounts and rates.
• Coordinate with TPA/Insurance for pre-authorization and settlements.
• Handle final discharge billing accurately and within targets.
• Coordinate with various departments for pending charges and clearances.

Skills

Core Billing

IPD Billing

TPA/Insurance Billing

PSU/Government Billing

Corporate Panel Billing

Cashless Billing

Billing Reconciliation

Job description

Job Purpose

Aakash Hospital, Dwarka is looking for an experienced Billing Executive Core Billing who will be responsible for managing end-to-end hospital billing, with major focus on IPD/Core Billing, TPA, PSU, Corporate Panels and Final Discharge Billing.

The candidate should have practical knowledge of hospital tariffs, packages, TPA/Insurance processes, PSU and corporate panel requirements, cashless approvals, billing reconciliation, deductions, advances and final settlement.

The person should be capable of ensuring accurate billing, minimum revenue leakage and timely final discharge clearance.

Role & responsibilities

1. Core Hospital Billing

• Handle complete IPD/Core Billing from admission to final discharge.


• Prepare and maintain interim and final patient bills.


• Ensure all services provided to the patient are accurately posted in the billing/HIS system.


• Verify:


• Room and bed charges


• Doctor/consultant visits


• Nursing charges


• Laboratory investigations


• Radiology


• Pharmacy


• OT/procedure charges


• Anesthesia


• Implants


• Consumables


• Blood bank


• Physiotherapy


• Miscellaneous services


• Verify applicable tariffs, packages, discounts and approved rates.


• Identify missed, duplicate or incorrect charges and coordinate for correction.


• Monitor patient ledgers and outstanding balances.


• Ensure proper adjustment of patient advances/deposits.

2. TPA & Insurance Billing

• Handle TPA/Insurance cashless billing from admission through discharge.


• Verify patient eligibility, authorization and entitlement.


• Check approved package/rates and room eligibility.


• Coordinate for pre-authorization, enhancement and final approval.


• Monitor the approved amount against the actual treatment cost.


• Prepare interim bills and supporting documents whenever required.


• Ensure final billing is aligned with approved authorization and applicable TPA guidelines.


• Identify patient-payable and non-payable items.


• Coordinate with the TPA/Insurance desk regarding queries, deductions and discrepancies.


• Ensure all required documents are complete before final submission/closure.

3. PSU / Government Panel Billing

• Handle billing for PSU and Government panel patients.


• Verify eligibility, referral/authorization and entitlement.


• Apply applicable PSU tariffs, packages and approved rates.


• Ensure billing is strictly as per the relevant panel guidelines/agreement.


• Verify room entitlement and package applicability.


• Identify non-payable items and patient-payable components.


• Coordinate with the concerned PSU/TPA desk for approvals and clarification.


• Maintain complete supporting documentation.


• Prepare accurate final/credit bills and assist in resolving deductions and queries.

4. Corporate Panel Billing

• Handle Corporate Panel/Credit Billing for patients covered under corporate tie-ups.


• Verify corporate authorization, employee ID, entitlement and applicable terms.


• Understand and apply different corporate tariffs, packages, room eligibility and billing conditions.


• Candidate should have knowledge of handling multiple corporate panels, rather than being dependent on one particular panel.


• Coordinate with Corporate/TPA Desk for authorization and clarification.


• Ensure correct segregation of:


• Corporate payable amount


• Patient payable amount


• Co-payment


• Non-payable items


• Approved discounts


• Prepare accurate credit bills as per corporate agreement.


• Ensure proper supporting documents are available for bill submission.


• Follow up on billing queries and discrepancies.

5. Final Discharge Billing Primary Responsibility

The candidate will be responsible for accurate and timely Final Discharge Billing.

Before Final Bill Preparation:

• Review the complete patient account.


• Verify all charges from admission until discharge.


• Check room/bed charges and room upgrades/downgrades.


• Verify consultant and professional charges.


• Check pharmacy and consumable entries.


• Verify investigation and diagnostic charges.


• Check OT/procedure and anesthesia charges.


• Verify implants and high-value consumables.


• Check package inclusions and exclusions.


• Verify all approved discounts.


• Check TPA/Insurance/PSU/Corporate approvals.


• Verify enhancement approvals.


• Ensure no pending charge entries remain.


• Coordinate with Nursing, Pharmacy, Diagnostics, OT, MRD and other departments for pending charges.

Final Settlement:

• Prepare the final discharge bill accurately.


• Reconcile the complete patient account.


• Adjust all advances/deposits.


• Calculate patient payable/refundable amount.


• Verify TPA/Insurance/Corporate/PSU approved amount.


• Ensure correct application of package and tariff rates.


• Coordinate with the concerned desk for final authorization.


• Coordinate with Cash/Accounts for collection or refund.


• Complete billing clearance within the defined Discharge TAT.


• Escalate any issue that may delay discharge.

6. Advance & Reconciliation

• Verify all advances/deposits received from patients.


• Ensure correct posting of advances in the system.


• Reconcile advance balance with the final bill.


• Identify additional collection requirements.


• Ensure correct refund calculation wherever applicable.


• Coordinate with Cash/Accounts for refunds and collections.


• Maintain proper documentation for adjustments.

7. Package & Tariff Management

• Have good understanding of hospital packages and tariffs.


• Verify package applicability before final billing.


• Ensure package-included items are not billed incorrectly.


• Identify package exclusions/non-package services.


• Apply applicable TPA, PSU and Corporate rates.


• Verify discounts and approvals before bill closure.


• Escalate tariff discrepancies to the Billing Manager.

8. Billing Accuracy & Revenue Leakage

• Review bills to identify missed or incorrect charges.


• Prevent duplicate billing.


• Ensure correct tariff application.


• Verify approved discounts and adjustments.


• Identify potential revenue leakage.


• Ensure all services rendered are captured in the final bill.


• Follow hospital billing SOPs and financial controls.


• Maintain proper audit trails for corrections and adjustments.

9. Department Coordination

The Billing Executive will coordinate closely with:

• Front Office / Registration


• Admission Department


• Nursing Department


• Doctors/Consultants


• Pharmacy


• Laboratory


• Radiology


• OT


• Cath Lab


• Blood Bank


• Medical Records Department


• TPA/Insurance Desk


• Corporate Desk


• PSU Desk


• Cash Counter


• Accounts & Finance


• Revenue Cycle/MIS Team

The candidate must proactively follow up for pending charges, documents, approvals and clearances to avoid discharge delays.

10. Patient & Attendant Handling

• Respond professionally to patient/attendant billing queries.


• Explain outstanding amounts and final settlement where required.


• Coordinate with TPA/Corporate/PSU teams for clarification of payable and non-payable amounts.


• Handle billing-related complaints professionally.


• Escalate complex disputes to the Billing Manager.


• Maintain confidentiality of patient and financial information.

Mandatory Skills

• Core Hospital/IPD Billing


• Final Discharge Billing


• TPA/Insurance Billing


• PSU/Government Panel Billing


• Corporate Panel Billing


• Cashless Billing


• Credit Billing


• Package Billing


• Tariff Knowledge


• Advance & Deposit Reconciliation


• TPA/Corporate Approval Process


• Final Authorization


• Billing Documentation


• Hospital HIS/Billing Software

Experience

2 - 5 years of relevant experience in hospital billing, preferably in a multi-specialty hospital.

Candidates with hands-on experience in Core Billing + IPD Billing + Final Discharge Billing + TPA + PSU + Corporate Panels will be preferred.

Ideal Candidate Profile

The ideal candidate should be a hands-on Hospital Billing Executive with strong experience in Core/IPD Billing and Final Discharge Billing, along with practical knowledge of TPA, Insurance, PSU and multiple Corporate Panels.

The candidate should be able to independently review a patient's complete account, verify all charges and approvals, reconcile advances, prepare the final bill, coordinate with internal departments and external panels, and complete the final discharge settlement accurately and within the required TAT.