Ip Billing Executive/ Senior Executive

Key Responsibilities

Inpatient Billing Operations

• Prepare and finalize inpatient bills with 100% accuracy.
  
• Monitor and update provisional bills daily for admitted patients.
  
• Post all charges (consultation, procedures, pharmacy, diagnostics, room rent, consumables, etc.) correctly.
  
• Ensure billing adherence to hospital tariffs, package policies, and inclusions/exclusions.
  

TPA/Insurance Coordination

• Handle admission intimation and obtain pre-authorization from TPAs/insurance companies.
  
• Submit necessary documents (admission notes, investigations, treatment plans) to insurance/TPAs on time.
  
• Track and follow up on approvals, enhancements, and extensions for continued stay.
  
• Align final billing strictly as per TPA/insurance approval limits and policy guidelines.
  
• Resolve TPA-related billing discrepancies with proper documentation.
  
• Coordinate with consultants for timely discharge summary, medical records, and required justification for claim approvals.
  
• Ensure discharge is processed only after receipt of TPA final approval/guarantee of payment.
  

Patient Interaction & Support

• Counsel patients/attendants on billing and insurance queries.
  
• Share cost estimates and provisional updates transparently during hospitalization.
  
• Provide clarity on insurance coverage, co-payments, and exclusions.
  

Audit, Compliance & Reporting

• Reconcile daily billing and insurance transactions.
  
• Maintain accurate billing and insurance records for audits.
  
• Ensure compliance with NABH/JCI and hospital billing guidelines.
  
• Prepare periodic MIS reports on IP billing, TPA receivables, and claim status.
  

Team & Process Management

• Support and guide junior billing/TPA staff.
  
• Identify gaps in billing/TPA processes and suggest improvements.
  
• Escalate unresolved cases to Billing Manager for timely closure.
  

Key Skills & Competencies

• Strong knowledge of hospital IP billing & TPA/insurance processes.
  
• Proficiency in Hospital Information Systems (HIS) and billing software.
  
• Good communication, negotiation, and counseling skills.
  
• Detail-oriented with strong numerical and analytical ability.
  
• Ability to handle billing disputes diplomatically under pressure.
  

Qualification & Experience

• Graduate in Commerce / Finance / Hospital Administration (MBA preferred).
  
• 47 years of experience in hospital IP billing and TPA operations.
  
• Hands-on experience in insurance/TPA pre-authorization, approvals, and claims mandatory.