Job Title: Billing Executive

Department: Billing

Location: Andheri

Qual: Graduate (B.Com / BBA / BMS / B.Sc)

Experience: 2 to 6 years of experience in hospital billing (OPD/IPD/TPA) with exposure to TPA/cashless, IP discharge billing & audits

Role Purpose: 

To ensure accurate, timely, and error‑free billing for all inpatient, outpatient, emergency and TPA/cashless services by adhering to hospital policies, tariff structures, statutory requirements, and patient communication standards for Andheri Unit. The role supports revenue integrity through proper documentation, charge capture, reconciliation, and coordination with clinical and non‑clinical teams.

Key Responsibilities:

Billing Operations – OPD / IPD / Emergency

• Generate accurate bills for consultations, procedures, diagnostics, pharmacy, consumables, room charges, and other services.
• Ensure timely registration, episode creation, and patient category selection (cash, credit, TPA, corporate).
• Verify all charge capture entries based on orders, documentation, and charge sheets.
• Handle advance collection, deposits, refunds, discharge bill preparation, and bill closure.
• Coordinate with nursing/ward staff for final bundle closure, consumable capture, and doctor visit postings

TPA / Corporate / Cashless Billing

• Verify TPA approvals, inclusions, exclusions, sub-limits, and balance amount collection.
• Coordinate with TPA desk for pre-authorizations, enhancements, billing queries, and final bill preparation.
• Ensure billing as per package terms, tariff, and corporate agreements

Cashiering & Financial Compliance

• Handle patient payments (cash, card, UPI, digital wallets, cheques) and issue receipts.
• Maintain cash drawer, reconcile end‑of‑day cash/card statements, and deposit as per finance protocols.
• Ensure zero variance in cash handling and follow all financial SOPs.

Documentation & Audit Readiness

• Ensure proper uploading and maintenance of all supporting documents (doctor notes, consent forms, orders, approvals).
• Maintain complete file accuracy for audits—clinical, financial, statutory.
• Support internal/external audits by providing required billing data.

Patient Coordination & Service Excellence

• Resolve billing queries from patients, relatives, TPA coordinators, and internal departments promptly and professionally.
• Communicate transparently about estimates, deposits, final settlements, and insurance approvals.
• Provide empathetic assistance during discharge to ensure a smooth patient experience.

Systems, Reporting & Data Accuracy

• Update and maintain all billing data in HIS/EMR accurately.
• Generate MIS reports: daily billing, outstanding deposits, collection summary, credit billing status, etc.
• Identify billing gaps, charge misses, incorrect postings, and share corrective actions with the Billing Manager.

Compliance & Ethical Standards

• Ensure adherence to hospital tariff, discount policies, packages, and regulatory guidelines.
• Maintain strict confidentiality of patient and financial information.
• Follow organizational ethics, code of conduct, and high service standards.

Core Competencies

• Hospital billing flow (OP/IP/TPA)
• Charge capture & revenue cycle basics
• Knowledge of healthcare tariffs, packages, insurance norms
• Cash handling & reconciliation
• Proficiency in HIS/EMR (e.g., SAP/HIS/RFH system)
• Communication & customer service
• Attention to detail & audit readiness