We are looking for a proactive and customer-focused Front Office Executive – Billing & TPA to join our hospital team. The ideal candidate should have experience in hospital front office operations, OPD/IP billing, and TPA/insurance coordination, with excellent communication and organizational skills.
Front Office & Patient Services
- Welcome and assist patients and visitors professionally.
- Register new patients and maintain accurate patient records.
- Schedule, reschedule, and confirm patient appointments.
- Manage patient check-in and check-out processes.
- Handle patient inquiries via phone, email, and in person.
OPD & IP Billing
- Generate OPD consultation, investigation, procedure, pharmacy, and daycare bills.
- Prepare IP admission files and discharge billing.
- Process advance payments, refunds, and final settlements.
- Ensure billing accuracy before patient discharge.
- Maintain daily billing and cash collection reports.
- Coordinate with doctors, nursing, laboratory, pharmacy, and other departments for billing activities.
TPA & Insurance Coordination
- Handle cashless and reimbursement insurance cases.
- Collect and verify insurance-related documents.
- Submit pre-authorizations to TPAs and insurance companies.
- Coordinate with insurers for approvals, queries, and discharge clearances.
- Upload medical records and billing documents on insurance portals.
- Follow up on pending approvals and maintain claim documentation.
Administrative Responsibilities
- Maintain patient records in the Hospital Information System (HIS).
- Ensure compliance with hospital billing policies and insurance guidelines.
- Coordinate daily reconciliation with the Accounts team.
- Prepare daily MIS reports related to billing and TPA cases.
- Maintain confidentiality of patient information.
EducationGraduate in any discipline (B.Com/BBA preferred).Certification in Hospital Administration or Medical Billing is an added advantage.
Required Skills
- Knowledge of Hospital Information Systems (HIS).
- Hands-on experience in OPD & IP billing.
- Understanding of TPA and insurance claim processes.
- Good communication and interpersonal skills.
- Proficiency in MS Excel, MS Word, and email communication.
- Strong customer service orientation.
- Ability to multitask and work under pressure.
Preferred Knowledge
- Cashless authorization process.
- Medical terminology.
- Health insurance documentation.
- NABH documentation practices.
- Oncology billing (preferred).
Maintain billing accuracy of 99% or above.Timely submission of insurance pre-authorizations.Minimize billing errors and claim rejections.Deliver excellent patient service at the front office.Complete daily billing and cash reconciliation on time