Operations Manager

Aster DM Healthcare; Nampally; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Aster DM Healthcare in Hyderabad seeks an experienced Manager – IP & OP Billing & Financial Counselling to oversee hospital billing operations, revenue management and patient financial counselling. You will ensure accurate billing, coordinate with clinical and admin teams and drive policy adherence.

The role requires strong expertise in IP & OP billing, insurance/TPA processes, government schemes and revenue cycle management, with a focus on quality, compliance and patient satisfaction.

Qualifications

• Graduate or postgraduate in finance, hospital administration, healthcare management or related field.
• 8–12 years of relevant hospital billing / revenue cycle experience.
• Strong experience in IP & OP Billing and Financial Counselling.

Responsibilities

• Lead IP/OP billing operations and ensure timely patient bills.
• Oversee financial counselling and explain costs, deposits and options.
• Coordinate with Insurance/TPA for claims and government schemes.
• Monitor full revenue cycle from registration to settlement.
• Manage billing audits, discounts, refunds and write-offs.
• Supervise and develop IP/OP billing and counselling teams.
• Coordinate with doctors, nursing, admin and finance for billing needs.
• Prepare regular MIS reports on billing and collection performance.

Skills

IP Billing

OP Billing

Financial Counselling

Revenue Cycle Management

Team Leadership

Education

Graduate / Postgraduate in Finance, Hospital Administration, Healthcare Management, Commerce or related field

Job description

Position: Manager IP & OP Billing & Financial Counselling

• Department: Billing / Revenue Cycle Management
• Designation: Manager
• Location: Nampally
• Industry: Hospital / Healthcare
• Reporting To: Unit Head / Hospital Administration / Finance Head

Job Summary

We are looking for an experienced and result-oriented Manager – IP & OP Billing & Financial Counselling to oversee hospital billing operations, revenue management, and financial counselling services. The role will be responsible for ensuring accurate and timely billing, effective coordination with clinical and non-clinical departments, smooth patient financial counselling, and adherence to hospital policies and statutory requirements.

The candidate should have strong knowledge of IP & OP billing, insurance/TPA processes, government schemes, cash billing, credit billing, financial counselling, collections, and revenue cycle management.

Key Responsibilities

1. IP & OP Billing Operations

• Manage and supervise day-to-day IP and OP billing operations.
• Ensure accurate and timely generation of patient bills.
• Monitor admission, discharge, interim and final billing processes.
• Ensure proper posting of services, procedures, pharmacy, investigations, implants and other chargeable items.
• Monitor billing errors, cancellations, refunds, discounts and adjustments.
• Ensure proper documentation and authorization for all billing transactions.
• Resolve billing-related issues and patient queries promptly.

2. Financial Counselling

• Lead the Financial Counselling team and ensure effective counselling of patients and attendants.
• Explain estimated treatment costs, packages, deposits, room charges and other financial requirements.
• Provide patients with clear information regarding treatment-related expenses.
• Counsel patients regarding available payment options, insurance/TPA coverage and applicable hospital schemes.
• Ensure timely communication of revised estimates in case of changes in treatment plans.
• Handle escalated financial concerns and support patient satisfaction.

3. Insurance / TPA / Government Schemes

• Coordinate with Insurance and TPA teams for smooth claim processing.
• Monitor pre-authorizations, enhancements, approvals and final claim submissions.
• Ensure proper documentation and timely submission of claims.
• Monitor pending approvals, deductions, rejections and claim discrepancies.
• Coordinate with concerned departments for resolution of insurance/TPA issues.
• Ensure effective handling of applicable government and corporate schemes such as CGHS, EHS and other empanelled schemes, as applicable.

4. Revenue Cycle Management

• Monitor the complete billing and collection cycle from registration/admission to final settlement.
• Track outstanding amounts and ensure timely collection.
• Monitor credit patients, corporate accounts, insurance receivables and other outstanding balances.
• Analyze revenue leakage and implement corrective measures.
• Prepare and review daily, weekly and monthly billing and collection reports.
• Monitor key revenue and billing performance indicators.

5. Team Management

• Lead, supervise and motivate IP billing, OP billing and financial counselling teams.
• Allocate responsibilities and ensure adequate manpower coverage.
• Conduct regular team meetings and performance reviews.
• Identify training requirements and provide necessary guidance.
• Establish and monitor team productivity and quality standards.
• Ensure adherence to hospital SOPs and billing policies.

6. Coordination

• Coordinate closely with Doctors, Nursing, Front Office, Medical Records, Pharmacy, Diagnostics, OT, Finance, Insurance/TPA and Administration teams.
• Ensure timely communication between clinical and billing departments.
• Coordinate with doctors and clinical teams regarding package applicability, procedures and billing requirements.
• Support smooth discharge and settlement processes.

7. Audit & Compliance

• Ensure compliance with hospital billing policies, SOPs and applicable statutory requirements.
• Conduct regular billing audits to identify errors and revenue leakages.
• Ensure proper authorization for discounts, refunds, write-offs and adjustments.
• Maintain confidentiality and security of patient financial information.
• Support internal and external audits whenever required.

8. MIS & Reporting

Prepare and review regular reports including:

• IP Billing Revenue
• OP Billing Revenue
• Daily Collection Report
• Pending Billing Report
• Outstanding Report
• Insurance / TPA Pending Report
• Discharge Billing TAT
• Financial Counselling Conversion / Collection Report
• Discounts and Refunds Report
• Revenue Leakage / Billing Error Report
• Department-wise revenue performance

Key Performance Indicators (KPIs)

• Billing accuracy and error percentage
• IP & OP billing turnaround time
• Discharge billing TAT
• Collection efficiency
• Outstanding reduction
• Insurance/TPA claim submission TAT
• Reduction in claim rejections and deductions
• Financial counselling effectiveness
• Revenue leakage reduction
• Patient satisfaction related to billing
• Team productivity and manpower utilization

Eligibility & Experience

• Graduate / Postgraduate in Finance, Hospital Administration, Healthcare Management, Commerce or related field.
• 8–12 years of relevant experience in hospital billing / revenue cycle management, with managerial or supervisory experience.
• Strong experience in IP & OP Billing and Financial Counselling.
• Experience in a hospital environment is mandatory/preferred.
• Good knowledge of Insurance, TPA, Corporate Billing and Government Schemes.
• Experience handling billing teams and coordinating with multiple hospital departments.