Job Description: Executive – PMJAY / Ayushman Bharat Operations
Position Overview
Job Title
Executive – PMJAY / Ayushman Bharat Operations
Department
Billing & Government Health Schemes (TPA / PMJAY Desk)
Experience Required
0 to 2 Years (Freshers Or Hospital Administration/Life Sciences background welcome)
Take-Home Salary
Up to ₹25,000 per month (in-hand, commensurate with experience)
Employment Type
Full-time, On-site
Role Purpose
The PMJAY Executive manages the end-to-end processing of beneficiaries under the Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and associated state government health schemes. The role ensures prompt eligibility verification, pre-authorization submissions, query resolution, and timely claim settlements while upholding hospital service standards.
Key Responsibilities
● Beneficiary Verification: Verify patient credentials and eligibility on the National Health Authority (NHA) / BIS portal using Golden Cards, Aadhaar, Ration Cards, or PMJAY letters at admission.
● Pre-Authorization Workflow: Coordinate with duty medical officers, nursing staff, and billing to compile diagnostic reports, clinical summaries, and treatment plans for timely pre-auth submission on the TMS portal.
● Case Paper & File Management: Maintain and assemble comprehensive indoor case papers, OT notes, implant stickers, investigation charts, and pharmacy records in accordance with SHA/ISA guidelines.
● Query Tracking & Resolution: Proactively monitor portal status, address medical/administrative queries raised by State Health Agencies (SHA) or Implementation Support Agencies (ISA), and prevent claim delays.
● Discharge & Claim Settlement: Facilitate discharge documentation, complete biometric verification where mandated, and submit final claim packages within prescribed turnaround times (TAT).
● Patient & Attendant Counseling: Guide beneficiaries through package inclusions, exclusions, and documentation prerequisites clearly and empathetically.
Candidate Profile & Qualifications
● Education: Bachelor’s Degree in any discipline (BHA, B.Sc, B.Com, BA, BCA, B.Pharm) or Diploma in Hospital Administration / Medical Record Technology.
● Technical Skills: Proficiency in MS Excel, web-based portal navigation, and data entry. Prior exposure to the NHA TMS portal or Hospital Information Systems (HIS) is advantageous.
● Medical Familiarity: Basic understanding of clinical terminology, diagnostics, and surgical package definitions.
● Communication: Good verbal and written communication skills in regional language, Hindi, and basic English.
● Work Approach: Strong attention to documentation accuracy, time management, and ability to handle desk coordination during high footfall hours.
Pay: ₹10,832.87 - ₹25,000.00 per month
Benefits:
- Cell phone reimbursement
- Flexible schedule
- Paid sick time
- Provident Fund
Application Question(s):
- Current CTC ?
- Expected CTC ?
- Notice Period ?
Education:
Location:
- Rajkot, Gujarat (Rajkot) (Preferred)
Work Location: In person
