Finance Auditor - Hospital Pharmacy

Job Summary

The Finance/Billing Auditor – Pharmacy is responsible for ensuring the accuracy, transparency, and compliance of all financial transactions related to pharmacy operations. This includes billing, revenue recognition, discounts, credit management, GST compliance, and ensuring that all cashless and cash transactions are properly recorded and reconciled.

This role plays a critical part in revenue assurance, financial control, regulatory compliance, and prevention of revenue leakage in hospital pharmacy operations.

Key Responsibilities

1. Billing Audit & Verification

· Review all pharmacy bills generated through HIS/ERP to ensure correctness of pricing, discounts, and tax components.

· Verify alignment between dispensed items and billed items.

· Identify and flag duplicate or cancelled bills.

· Monitor manual billing or overrides in the system.

2. Revenue Reconciliation

· Reconcile daily, weekly, and monthly revenue between system reports and finance records.

· Match sales reports with physical stock movement.

· Ensure proper accounting of cash, credit, insurance, and corporate billing.

· Track return and refund transactions and ensure proper documentation.

3. Pricing & Discount Compliance

· Verify that approved pricing (MRP / hospital price list) is correctly configured in the system.

· Audit discount approvals and ensure they are as per organizational policy.

· Ensure no unauthorized price modifications are being made.

4. Regulatory & Taxation Compliance

· Ensure GST is applied correctly on all billed items.

· Verify that billing complies with NDPS, Schedule H/H1, and other regulatory requirements.

· Support finance team in accurate tax reporting and filing.

5. Internal Controls & Fraud Detection

· Audit high-value transactions, abnormal billing patterns, and backdated entries.

· Detect revenue leakages, manipulation, or fraudulent billing practices.

· Ensure segregation of duties between pharmacy, billing, and finance teams.

· Review credit note/debit note issuance.

6. Process Compliance

· Ensure adherence to billing SOPs, especially for inpatient, outpatient, emergency, and corporate patients.

· Verify turnaround time between dispensing and billing.

· Check for zero-value or unbilled issues in the system.

7. Reporting & CAPA

· Prepare daily / weekly / monthly billing audit reports.

· Highlight deviations, anomalies, and risks to management.

· Recommend corrective and preventive actions (CAPA).

· Follow up with concerned departments to ensure closure.

8. Cross-Department Coordination

· Coordinate with pharmacy, IT, finance, insurance, and front office teams for issue resolution.

· Support NABH/JCI/ISO audit documentation from a financial compliance perspective.

· Provide data to management for decision-making and revenue forecasting.

Required Skills & Competencies

· Strong understanding of pharmacy billing processes in hospitals.

· Proficiency in HIS/ERP, Excel, and financial reconciliation.

· Knowledge of GST, TDS, and healthcare billing regulations.

· Analytical mindset with attention to detail.

· Good understanding of revenue cycle management (RCM).

· Knowledge of internal controls and fraud risk indicators.

· Excellent documentation, reporting, and communication skills.

Qualification & Experience

· B.Com / M.Com / MBA Finance / CA (Inter) / CMA or equivalent.

· 3–5 years of experience in healthcare finance or billing audit (hospital or pharmacy domain preferred).

· Knowledge of HIS/ERP systems such as HIS, SAP, or equivalent hospital billing software.

· Familiarity with NABH / JCI accreditation standards is a plus.

Key Performance Indicators (KPIs)

Billing Accuracy

% of bills with zero discrepancies

Revenue Reconciliation

Timeliness and accuracy of daily/monthly reconciliations

Leakages Detected

No. and value of revenue leakages identified and resolved

Discount Compliance

% adherence to approved discount policy

Turnaround Time

Speed of issue resolution and audit reporting

CAPA Closure

Closure rate and time of audit findings

Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹50,000.00 per month

Benefits:

• Health insurance
• Leave encashment
• Paid sick time
• Paid time off
• Provident Fund

Ability to commute/relocate:

• Lucknow, Uttar Pradesh: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

• Are you available to join us before 5th of November? ( Mandatory)
• Your last in hand salary?

Education:

• Bachelor's (Required)

Experience:

• Healthcare Finance Auditor: 3 years (Required)
• Billing Audit: 3 years (Required)
• Regulatory Compliance and Taxes: 3 years (Required)

Willingness to travel:

• 75% (Required)

Work Location: In person