Billing Executive - Customer Experience (In Patient)

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.

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.

- 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; escalate 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.

Ensure adherence to all Billing protocols

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.

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.

- 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; escalate 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 patient’s 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; TAT’s; maintain and update cashless tracker outstanding.

- Aware of escalation matrix.

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.