Billing Executive (IP)

Motherhood Hospital - Indore (Rhea Healthcare); Indore District; On-site; INR 250,000 - 360,000; Full time

Job summary

Motherhood Hospital - Indore (Rhea Healthcare) is seeking a Billing Executive to manage hospital billing, insurance reimbursements, and cash transactions. You will ensure accurate entry of services, maintain records, and explain charges to patients and attendees.

The role involves coordinating with admissions and department staff, ensuring timely settlement and proper documentation, and maintaining SOP-compliant workflows in the Hospital Information System.

Qualifications

• Experience in hospital billing and insurance processes.
• Ability to manage cashless and cash transactions.
• Proficiency in explaining charges and resolving queries.

Responsibilities

• Ensure all charges are billed correctly and payments collected on time.
• Handle cashless insurance reimbursements and cash transactions end to end.
• Explain charges to customers and resolve queries.
• Maintain accurate billing records and documentation.

Skills

Strong functional knowledge

Numeric skills

Computer literacy

Tools

Billing software

HIS system

Job description

Role & responsibilities

Ensure all charges are correctly billed and payment collected on time.

• Cashless ~ all activities related to insurance reimbursement.
• Cash ~ end to end management of transactions.
• Query handling ~ understand charges, explain and resolve customer queries.
• Records ~ ensure billing and accounting records and documentation are maintained accurately and manage account payments.

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.
• - 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.
• - Aware of escalation matrix.

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.

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.

Preferred candidate profile

• - Strong functional knowledge.
• - Competence in:- account processes and costing; numeric skills; computer skills , understands software and capable of accurate entries and updation.