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Motherhood Hospital (Rhea Healthcare) in Pune invites a billing professional to manage end-to-end hospital invoicing and payments. You will ensure accurate entry of charges, cashless and cash transactions, and maintain compliant records. The role requires strict adherence to SOPs, effective communication with insurance providers, and timely reporting.
On-site hospital environment with collaborative teams. Experience with HIS and patient billing processes is preferred; the position emphasizes
Ensure all charges are correctly billed and payment collected on time.
At Admission:
- Confirm the customer has been given the package cost estimation document and is clear about it.
Cashless Transactions:
Prior to admission -
- Collect required documents from customer; confirm eligibility and prepare pre-authorization form.
- Submit completed documents to Insurance company.
- Once authorization received, update the customer.
At Admission -
- In case pre-auth has not been received , collect Interim Advance; amount as per SOP.
Cash Transactions:
- Collect advance as per SOP.
Billing activities:
- Competently operates the Billing module on Hospital Information System.
- Capable of operating the barcoding / credit card machine for receiving payments.
- Once patient is admitted, raise all documents as per SOP.
- Update all IP folios based on entries on the Activity Sheet charges for diagnostics, lab, medications, and services given to patients.
w Based on Consultant advice, Ward raises the Request Form to concerned dept for the
investigation; Doctor/technician completes the investigation and updates the Activity Sheet.
- Consultant visits to the patient are tracked; patient folio is updated with consultant charges where applicable as per category of consultants (specialist, super specialist)
- Bed side procedures are tracked and billed.
- Ensure credit balance is maintained; when the amount crosses threshold, request patient attendant to pay; elevate to reporting Manager / Facility Director in case of non-payment.
- To provide interim provisional bill as per SOP to attender & insurance.
- Ensuring referral doctor charges are included in Billing, from Activity Sheet.
- Confirm all charges have been entered in the final bill before settlement and discharge.
- To compile all investigation reports, supporting documents for charges, Discharge Summary & other relevant documents along with the patients final Bill.
- To maintain individual TPA status as regard to the Outstanding, Bills Submitted & Payment Status.
- Responsible for all Billing related Reports : daily collection Report; discharge report; TATs; maintain and update cashless tracker outstanding.
At Admission:
- Confirm the customer has been given the package cost estimation document and is clear about it.
Cashless Transactions:
Prior to admission -
- Collect required documents from customer; confirm eligibility and prepare pre-authorization form.
- Submit completed documents to Insurance company.
- Once authorization received, update the customer.
At Admission -
- In case pre-auth has not been received , collect Interim Advance; amount as per SOP.
Cash Transactions:
- Collect advance as per SOP.
Billing activities:
- Competently operates the Billing module on Hospital Information System.
- Capable of operating the barcoding / credit card machine for receiving payments.
- Once patient is admitted, raise all documents as per SOP.
- Update all IP folios based on entries on the Activity Sheet – charges for diagnostics, lab, medications, and services given to patients.
w Based on Consultant advice, Ward raises the Request Form to concerned dept for the
investigation; Doctor/technician completes the investigation and updates the Activity Sheet.
- Consultant visits to the patient are tracked; patient folio is updated with consultant charges where applicable as per category of consultants (specialist, super specialist)
- Bed side procedures are tracked and billed.
- Ensure credit balance is maintained; when the amount crosses threshold, request patient attendant to pay; elevate to reporting Manager / Facility Director in case of non-payment.
- To provide interim provisional bill as per SOP to attender & insurance.
- Ensuring referral doctor charges are included in Billing, from Activity Sheet.
- Confirm all charges have been entered in the final bill before settlement and discharge.
- To compile all investigation reports, supporting documents for charges, Discharge Summary & other relevant documents along with the patient’s final Bill.
- To maintain individual TPA status as regard to the Outstanding, Bills Submitted & Payment Status.
- Responsible for all Billing related Reports : daily collection Report; discharge report; TAT’s; maintain and update cashless tracker outstanding.
- Aware of escalation matrix.
At Discharge :
- Hand over complete set of documents to the patient attender; take signature in the Hand over register as confirmation.
- Coordinate with TPA for final authorization; ensure within TAT.
- Ensure that there are no Billing delays during discharge of patients; to be within the Discharge TAT.
- Share Discharge TAT daily for every discharge – cash & cashless.
Doctor Accounting:
- Responsible for Visiting Consultants & Referral Doctor Accounting.
Blood: [ for Hospitals that do not have own blood bank]
- Arrange for blood as per doctors’ advice; check with empaneled blood banks, coordinate sending of blood sample for matching; either reserve the blood as per requirement or arrange for its delivery and payment.
Fulfilling the Service Vision & Inter-department Coordination:
- Is well-groomed as per standard; maintains discipline and decorum.
- Responsible for the implementation of the Service Vision – ensures personalized care while delivering service.
- Engages well with Clinicians and colleagues, builds respect and rapport.
- Coordinates with support departments to ensure customers are comfortable and services are as per standard.
- Maintains a cordial interpersonal relationship with all colleagues.
Personal Development:
- Attends in-service programs and trainings to enhance knowledge.
- Ensures is up to date with latest protocols and practices.
Strong functional knowledge.
- Competence in:- account processes and costing; numeric skills; computer skills , understands software and capable of accurate entries and updation.