Head- TPA & IPD Billing

Neelam Healthcare; Madhya Pradesh; On-site; INR 400,000 - 560,000; Full time

Job summary

Neelam Healthcare is seeking a management professional to oversee IPD operations, admission-discharge workflows, and billing coordination. You will drive tariff implementations, package alignment, and ensure timely TPA interactions, ensuring audit-ready bill processing and patient satisfaction.

The role requires supervising the IPD billing team, coordinating with doctors, and maintaining portals with patient records through discharge, while managing daily to monthly data presentations to senior

Responsibilities

• IPD- Patient conversion to IPD
• Preparing packages and implementation & coordination with Doctors Regarding Rate List
• Discount Management
• Admission and Discharge Process and maintaining discharge & admin TAT
• Estimate Tagging And Accuracy
• Bed Management
• Looking after the IPD Billing Team
• Data presentation to GM Ops and Medical (Daily, Weekly, Fortnightly and Monthly)
• Supervision of proper counselling patient's family & pre-Auth process
• Maintaining & uploading patient's files on the portal till discharge
• Coordination from patient's admission to discharge
• Billing Department handling, Implants bill updating & reconciliation
• Daily coordination with patient and hospital staff
• Counseling of patients and solving queries
• Rounds of admitted patients for queries
• Pricing - Implementation of new tariff for revenue enhancement
• Surgical packages preparations and implementations
• Tariff updation in system and new item surgery names with management approval
• Feedback Management & Training Management: handling grievances and improving patient satisfaction
• Liaising with other departments for closing complaints
• Department training for smooth processes
• Student training on hospital processes
• TPA: Heading TPA and Dispatch
• Team management for TPA process and quick approvals
• Bill Dispatch for further processing
• Emergency handling: patient query conversion to IPD
• TPA processes coordination with insurers (Cash & Credit – ECHS, Railways, ESI, PMJ/Ayushman & others)
• Awareness of insurance norms (PMJ/Ayushman, ESI, ECHS)
• Audit of Bills before discharge
• Refunds for IPD patients
• Roaster creation for staff in department & training
• Coordination with insurance companies for deductions & query resolution
• Ensuring approval information to Medical officer with file copy

Job description

• IPD- Patient conversion to IPD
• Preparing the packages and implementation of the same & Coordination with Doctors Regarding Rate List.
• Discount Management
• Responsible for Admission and Discharge Process and maintaining the discharge & admin TAT
• Estimate Tagging And Accuracy
• Bed Management
• Looking after the IPD Billing Team
• Daily, Weekly, Fortnightly and Monthly data presentation to GM Ops and Medical

superintendent / Management

• Supervision of proper counselling patient's family & pre-Auth process,
• Supervision of Maintaining & uploading patient's files on the portal till the discharge.
• Responsible for all co-ordination activities from patient's admission to discharge.
• Handling billing Department, Implants bill updating & reconciliation,
• Daily co-ordination with the patient and Hospital staff.
• Counseling of patients and solve their queries & try to
• Rounds of the hospital admitted patients for any queries
• Pricing- Implementation of new tariff for the revenue enhancement
• Surgical packages preparations and implementations
• Tariff Updation: Rates in system or item rates not in system or generate new item surgery names with approval of management.
• Feedback Management & Training Management: Patient Feedback and grievances handling and resolution and enhancing the patient satisfaction score
• Liaising with another department for the complaints closer
• Departmental training for the smoothness of the process
• Students training on the Hospital and Departmental process.
• TPA: Heading TPA and Dispatch
• Looking after the team for the smoothness of the TPA process and Approvals in a Short Time
• Bill Dispatch in minimum time for further processing
• Emergency: - Handling queries of patients and their attendants and conversion into IPD.
• Handling TPA related all process from billing to co-ordinate with TPA companies at the time admission & discharge( Cash & Credit- ECHS, Railways, ESI, PMJ/ Ayushman & other insurance companies) .
• Must be aware of norms of the insurance sector, PMJ/ Ayushman, ESI, ECHS and any other insurance company.
• Responsible for Audit of Bills before discharge of patient
• Responsible of Taking Refunds of IPD patients.
• Responsible for making Roaster of staff posted in Department & their training.
• Coordination with respective insurance companies for deduction and handling/Solving the query of bill though email or any other mode of communications
• Ensuring Approvals informations to Medical officer with copy in file