Billing & TPA Executive (1 week Night shift/month)
- Mumbai, Maharashtra
- Rs. 7,50,000 per year
- Contract
- Full-time
- Prepare accurate cost estimates for outpatient, inpatient, surgeries, and procedures.
- Ensure estimates include room charges, doctor fees, OT charges, consumables, and medications.
- Update billing records in the hospital management system (HIS).
- Handle provisional and final billing processes.
- Coordinate with the finance team to explain patient dues, deposits, and refunds.
- Liaise with insurance/TPA providers for pre-authorizations, approvals, and claims processing.
- Submit required documents and follow up on authorization status.
- Track and document communication with TPA partners.
- Educate patients on their insurance coverage, eligibility, and exclusions.
- Ensure timely submission of discharge summaries and final bills to TPA.
- Provide empathetic and clear communication to patients and families regarding billing and insurance.
- Handle patient concerns and escalate complex queries to the appropriate department.
- Guide patients through the admission and discharge financial processes.
- Ensure patient satisfaction through transparency and responsive service.
- Bachelors degree in Healthcare Administration, Commerce, or related field
- Minimum 16 years of experience in hospital billing, TPA coordination, or patient services
- Knowledge of insurance procedures and healthcare billing systems
- Proficient in MS Office and hospital information systems (HIS)
- Strong communication and interpersonal skills
- Fluency in English and local language
- Medical billing and coding knowledge
- TPA and insurance coordination
- Estimation and costing in healthcare
- Patient communication and conflict resolution
- Attention to detail and documentation
- Familiarity with NABH/JCI guidelines (preferred)
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